So Long, GoodBye
by Dawn N
Summary: The Winchester family is faced with a possible tragedy concerning one of their own when a hunt for an entity leaves one of them with an illness that isn't supernatural.
1. The Calm Before the Storm

Disclaimer: The characters of "Supernatural" were created by Eric Kripke and are owned by the CW Network and Warner Brothers Studio. No profit is being made.

**NOTE TO READERS: **This will most likely be a long chapter story. I tend toward stories that involve hurting one or both boys, etc. and usually health related issues and/or injuries. I hope you enjoy this story as it develops.

**SIDE NOTE:** In this Season One/Two AU fic everything is canon up until "Salvation." Caleb still died, but Pastor Jim wasn't killed. The Impala wreck happened, but John never had to bargain his life for Dean's instead the Colt and final bullet were enough for the YED deal.

The title of this story is inspired by the song of the same title by the group "10 Years"

**So Long, Good-Bye**

**Chapter One: The Calm Before the Storm**

By Dawn Nyberg

"_Sell my soul – I'll sell my soul, I've got nothing left to lose. Hurt myself -- I'll hurt myself cover my face with tattoos all of painted tears – one for each year that only could have been … anything I can do to keep you …"_ Lyric excerpt by Fisher, _Six Hundred Sixty-Six_

"Dean!" Sam screamed as he felt the force of the entity blow into the room. "Get the damn banishing spell done man," Sam squinted through the blowing whirlwind in the room.

"I'm hurrying," Dean yelled over the chaos. Dean hurriedly continued his long sweeping actions on the floor with the spray paint. It was a banishing symbol that would be followed by a brief incantation that would kill it. It was an intelligent entity and that just gave Dean the damn creeps but his geek little brother thought it was interesting … _interesting_ was not the word Dean would choose. "Sammy do your thing man, it's done."

Sam began reciting Latin and the wind picked up and within the whirlwind was a roar of not agony but feral rage. "You kill me … I take your days … I take your days … your life," the entity screamed but Sam continued. Suddenly, the entity materialized and slammed the youngest Winchester against the wall grabbing his throat. "Your days," it whispered into his ear with a loud hiss.

"Sammy!" Dean shouted trying to make it to his brother but the entity twisted its corporeal head all the way around reminding Dean of the Linda Blair scene in the _Exorcist_ minus the pea soup. Dean was thrown backward against the far wall and held in place like a pinned butterfly. Sam pushed out the Latin despite the pressure cutting off his air supply. The entity's head whipped back around as Sam finished the last line of the incantation. It sneered at the young Winchester. It reached up quickly with both hands and grabbed Sam's head in its' cold vice grip.

"My death will not be in vain," it looked into Sam and Sam flinched. "I take your days, your life," there was a white hot agony that seared into Sam's head and his vision flared out like a road flare and as he screamed the entity let loose with a one final feral scream both fury and agony and was gone. Dean felt the invisible force holding him to the wall lift and he was moving quickly across the room to his younger sibling.

"Sammy!" he shouted at the crumpled heap on the floor. He had heard the entity's words, its' threat. He slid to his knees at his brother's side. His finger's fumbled quickly at a frantic pace to locate the pulse on his brother's neck. He sighed in relief as he felt a strong albeit racing heartbeat. "Sammy?" his voice was softer yet urgent as he pushed back his brother's long bangs trying to evoke a response. Sam stirred. Dean breathed.

"D-Dean," Sam's voice held a hint of confusion as he attempted to move.

"Easy Sammy," Dean held him firmly to the floor. "What'd that thing do to you?"

"I'm okay," Sam blinked up into the concerned face of his older brother.

"You sure?" How many fingers?" He asked as he waved two in front of Sam's face.

"Two," he grumbled. "I'm fine got a bitch of a headache" he complained. "Damn thing tried to squeeze my head like a Florida orange." Dean frowned at the analogy. He felt compelled to still keep a hand on his brother.

"ER?" Dean asked the tentative question. Both brothers' had avoided hospitals as much as possible since the wreck over four months ago. Their father had gone back on the hunt vowing to get in touch when he had a solid lead. They had no Colt and no way of killing the damn demon. They had wanted to go with John but he slipped out into the night once Dean was released from the hospital. Now, it was the occasional text message or relayed messages through Bobby Singer who had put the boys up while Dean fixed the Impala.

"No," Sam asserted. "I'm fine … a couple Tylenol and a hot shower and I'm good." Dean eyed his brother for a hard, long moment. Sam looked a little pale but he'd seen him worse and they could both use a break.

"Okay, we crash at a motel and tomorrow how about we go to Bobby's for a couple days? The car needs a tire rotation anyway." Sam sighed but gave in. Bobby was a good family friend and both boys had known the man since they were small. Sam could remember a time he had actually called the man Uncle Bobby.

"Yeah, alright." Dean gave Sam a hand up. "Entity went poof?" he looked at brother. Dean smiled.

"Yep, its' ass is toast. This place is clean now." Sam nodded and offered his brother a lopsided grin.

**Two Days Later at Bobby's House**

Sam was finally glad to see that Dean had finally begun to stop looking at him waiting for the other shoe to drop after the entity's warning. Dean had hovered almost that entire night at the motel driving Sam nuts. He had tolerated his big brother's worried Mother Hen routine because he knew how it felt and had been in the same shoes. Now, two days later it appeared that Dean had finally stopped with the side glances and questions like, _you feelin' okay? Your head hurt? You okay?_ Sam looked out the window and watched Dean and Bobby hover over the engine of the Impala completing some maintenance. He was fine and thankful he had dodged a bullet, so to speak.

**One Month Later, Madison, Wisconsin**

Sam blinked with irritation at the road map as Dean drove down the interstate. He absently rubbed his eyes as he tried to clear the blurry vision. He was very close to admitting that he may need contacts and he thought quietly to himself, _that'll suck_. "Come on dude, which route will bypass the construction we're gonna hit in another ten minutes." Dean looked at Sam for a moment. He could see Sam squinting at the map and blinking a little. He had noticed the blinking and squinting a couple weeks ago. He smirked to himself as it dawned on him. "You turnin' into a four eyes on me Sammy?" Dean kidded. Sam glared at his older brother.

"Bite me," he snapped. "My eyes are just tired." He pushed the map away. "You figure out the map your damn self," he muttered. "I'm not your own personal navigation system," he complained.

"Yeah, _Tom Tom_, you're not." Dean looked at his brother for a moment and turned his eyes back to the road. He could see the traffic backing up ahead and opted to get off at the nearest exit. They'd figure out a way around the construction traffic. "Seriously, your eyes bothering you?"

"I'm fine," Sam muttered staring out the window.

"Uh huh," Dean mumbled. "You've been doing the squinting thing a couple weeks now Sam … I'm not clueless." Sam just turned and looked at his brother for a hard moment and turned back to watching the scenery. Dean drove through the city and Sam said nothing more. An idea sparked in Dean's head as he drove and saw a sign for the local shopping mall. Within in a few minutes Sam noticed that they had actually pulled to a stop and Dean was shutting off the engine. He looked up to see where they were.

"A mall?" Sam looked at his sibling confused. Dean shook his head and flicked his thumb toward a store front they were parked near. Sam twisted his head around to look and frowned. "_Eye Mart_," he glared.

"Yep, come on."

There was a ten minute _discussion_ between the brother's and it finally ended with Sam sitting in the waiting room with a scowl on his face. There were walk-in appointments and Dean made sure Sam got one. Dean sat leaning back and reading an abandoned magazine. "Sam Collins?" A young petite technician stood in her purple and pink scrubs. Sam stood up and cast a hard glare at his brother and started to leave with the tech.

"I'll be here Sammy," Dean said with an amused voice. Sam didn't turn around but Dean clearly saw his younger brother indiscreetly flip him the bird and he couldn't help but smile as he went back to his magazine.

**Forty Minutes Later **

Dean glanced at his watch. He wasn't sure how long eye exams ran but he was starting to admit he'd like to see his freakishly tall kid brother come down the hall. He'd give it another ten minutes and then he was asking the woman behind the check-in counter. Another few minutes later he caught sight of his brother loping down the hallway with the doctor. Dean stood up and walked toward Sam. "Everything okay?" he asked the doctor not bothering to trust Sam to tell him the truth.

"You must be the older brother that hogtied him here, huh?" Dean smirked. "He's fine," the doctor assured. "His eyes are healthy and I see no major eyesight deficits that will require any permanent correction …"

"But? I hear a but," Dean cast a worried glance at his brother who had an odd look on his face as he made no eye contact with his older brother.

"I've recommended some reading glasses for him when he's reading or doing computer work," Dean had to restrain a chuckle and now he understood the look on his little brother's face and Sam was well aware of the jokes that he would come up with to torture his younger sibling over the reading glasses. "Sam," the doctor turned to him. "Susanne will take you over to our reading glasses section based on my recommendations and you should be able to leave with a pair today to start using to reduce your eye strain, okay?"

"Thanks doc," Sam answered quietly and glanced at the doctor.

"It's not the end of the world Sam," the doctor encouraged. "It's reading glasses, no big deal."

**Thirty Minutes Later, the Mall Food Court**

Sam squinted at the posted food menus at the various vendors and Dean did chuckle then. "Use your glasses Sammy," Dean laughed.

"Shut up Dean," Sam growled.

"Whatever, I'm gonna go look at the Greek food." Sam watched his brother go. He frowned and then went back to squinting. He sighed and pulled out his glasses, so he could read the posted menu behind a plexi-glass case. He slid them on and cast a worried glance toward his brother's direction and there Dean was across the court watching him with a huge amused smile on his face. Sam frowned and went back to the menu.

**Two Weeks Later, Somewhere outside Terra Haute, Indiana**

"I wrote it all down for you Dean … how the hell is it my fault you couldn't get the Latin right?" Sam shouted as they walked away from the abandoned house they had just exorcised from an evil presence that had been attacking curious folk interested in the legends of the old farm house.

"Have you seen your writing lately … damn this is some kind of chicken scratch. You could have got us killed. Look at this mess. It's like you didn't give a damn toward the end and it's just a bunch of scribble. Damn it Sam, get your fucking head in the game."

"Screw you Dean," Sam huffed. He had to admit his writing had experienced some deterioration over the last week and sometimes it was even difficult for him to actually write but it wasn't every day, however it was more often than not over the last week. Maybe he'd start typing up everything on the computer that had to be easier, right? He went to quicken his step to further his distance from Dean and almost tripped but caught himself. Dean frowned at that.

"You okay?" he couldn't help himself. He could be pissed at Sam but no matter what nothing ever overrode his big brother radar.

"Fine, I just tripped," and that was the end of that.

"Bobby called last night while you were getting burgers," Dean said suddenly switching the subject and trying to smooth things over a little.

"What he'd want?"

"He'd like us to come to his place for Thanksgiving, man. He might not be a chef but it's a hot meal and it beats eating at some dive and sleeping in a sty. It's not like Dad's gonna call and have us meet up with him," Dean said solemnly. "So, what do you think?" Sam nodded and it was decided. They'd go to Bobby's and stay for a couple days or so. Sam couldn't deny his brother a decent meal and a clean bed at Bobby's. After all, he knew how much it ate his brother up to know that their Dad had abandoned them the moment Dean was going to be discharged from the hospital after the wreck. They knew about the deal for the Colt and last bullet to save Dean's life but their father's absence still hurt them both.

**One Week Later, Bobby's Place**

The older hunter had convinced the boys to stay a little longer especially since the weather had turned sour and he didn't think it was wise for them to be out driving. A South Dakota winter could be very unforgiving and brutal, anyway who needed to hunt during winter unless it was a real emergency. He had convinced them to stay on until at least after Christmas.

**Bobby's Place, December 20, 2005**

Dean stood at his brother's doorway with concern. Sam's sleeping patterns had become a little off, okay, a lot off in the last couple weeks he was waking up a lot and when he did sleep he had started having some repeat heavy duty dreams like he first had after Jessica. The last couple days it had seemed to regulate itself but Sam was worn out from the couple weeks of poor sleep and even now it was almost 11 AM and his kid brother was still curled up sleeping.

"He okay?" Bobby asked quietly as he spotted Dean standing in the threshold of Sam's bedroom. When the boys stayed with him they had their own rooms if they wanted them but sometimes they seemed to crash in the library or in one room, but this time around they had opted for their own space.

"Yeah, I think so," Dean answered quietly and pulled himself out of the doorway and eased the door closed. He started walking with Bobby down the stairs. "I'm glad it looks like he's finally getting some decent sleep. I don't know what's been going on with him the last couple weeks.

"So, you've noticed, huh?" Bobby said gently. He hadn't wanted to say anything just yet, but he had noticed something was off about Sam ever since they showed up for Thanksgiving … it was subtle then but now it was more glaring.

"What?" Dean stopped dead and looked at the older hunter. "What do you mean?"

"Well, he's been getting a little on the apathetic side in the last couple weeks or so, he hasn't been wanting to do much and this is Sam we're talking about, he's not even scouring books in my library feeding that book worm brain of his. You're right about his sleep, his sleep patterns have been a little wonky to say the least even more extreme than I'm used to seeing." Dean nodded. "He's been a lot more impatient and irritable and if you ask me Sam's always had the patience of Solemn but now…"

"He just has some bad days Bobby," Dean tried to calm his own fears.

"What about the slurring last Friday," Bobby pointed out. "It was like he couldn't get the words out and had trouble speaking. If I didn't know him like I do, I would have thought he was drinking in the afternoon."

"It went away," Dean said quickly. "He was exhausted Bobby, he was just tired that's all. He'd been up a couple nights in a row."

"You sure that's the only reason … maybe …"

"No maybes there is nothing wrong with Sam that a little solid sleep and some good healthy meals won't fix."

"You trying to convince yourself there kiddo," Bobby replied. "Look you boys are like family to me. I've known you both since you were little. Maybe, it wouldn't hurt for him to get a check-up that's all I'm saying." Dean offered a slight nod.

**Later that Day**

"I don't need a doctor Dean," Sam was irritated.

"Sammy, all I'm saying is that maybe a doc should take a look at you … even Bobby thinks there is something not right going on here. Please…"

"No, I don't want to. I feel fine, okay? Look if something else happens that you or Bobby thinks is _off_ as you put it then I'll consider it, okay? That work for you?" Dean didn't like the compromise but it would have to do for now. He nodded.

**January 2, 2006, Greene Memorial Hospital, South Dakota**

13 days since he'd had the conversation with his brother about something being off but he never thought he'd be sitting in the ER waiting with Bobby while his brother was taken for a CT scan. It was two days after Christmas that Sam started having trouble sitting down or getting back up from the couch. He couldn't seem to lower himself into a chair or couch gently he just started plopping down. His walking was a little unsteady and sometimes Dean found himself walking behind his kid brother to catch him if he took a nose dive. He had actually tripped on his own feet a couple of times and had fallen. He bobbed and weaved a little like he was walking on a boat in choppy water. Sam had tried to say it was an inner ear infection or a little touch of vertigo but Dean had thought it was crap. Sam put up a fight but finally lost when Dean walked into his room the morning of the day after New Year's and caught him trying to dress himself but he couldn't manage the zipper on his jeans and he was fumbling with the buttons on his flannel shirt. That had sealed his fate right then and there with his older brother. Dean and Bobby hauled him to the hospital that morning.

Dean and Bobby didn't care that it appeared the sudden difficulty had apparently abated as Sam demonstrated he could now work the zipper on his hoodie that he was putting on. It didn't matter … both hunters had Sam by each arm and were pulling him through the house to get him to the car.

**Two Hours Later**

"Family for Sam Collins?" Dean was up and walking quickly toward the doctor.

"That's me doc. How's my brother?" The physician looked at Bobby. "This is our uncle. How is he? What's wrong with him?"

"Well, the CT scan came up normal and his physical exam didn't come up with anything out of the ordinary and his blood tests came back normal."

"But he isn't normal there is something wrong," Dean pushed. He wanted some damn answers. This was his little brother and he'd see that Sam got what he needed, no matter what.

"Yes," the doctor conceded. "He experienced some slurred speech and difficulty speaking right before the CT scan. I was worried we were looking at some kind of cerebral event like a mini-stroke," the doctor saw Dean's eyes go wide in fear. He was quick to assure. "There was no evidence of that Mr. Collin's"

"Call me Dean … anything else happen?"

"I gave him some short cognitive neurological tests and there were one or two moments that I detected some cognitive delay …"

"Cognitive delay? Sam went to Stanford on a full ride scholarship, what the hell does cognitive delay mean?"

"It was transient and he passed the rest of the exams with flying colors…"

"But, there is something wrong," Dean asserted.

"What's the plan doc," Bobby chimed in.

"He needs a large scale medical center with a state of the art diagnostic department and a neurology department. Greene Memorial is a good hospital but we're small. I've done what I can and I'm recommending he be taken to another facility. I'm going to make some calls and see where I'd like to refer you, so in the mean time I'm going to release him into your care. If there are any more changes, please bring him back in."

"You're releasing him?" Dean was both relieved and angry.

"He isn't in any immediate risk and his CT and other exams were clear, so there is no reason to keep him, but should he become confused or experience some more sudden onset issues, please bring him back."

A short while later Sam was brought out to the waiting room in a wheel chair and then he was allowed to leave. Sam looked at Dean and Bobby, "don't look so worried guys. I'm alright," he tried to assure. Dean offered a tense smile and just squeezed his brother's shoulder reassuringly. They were all quiet as they walked to the car. Dean kept one hand on the small of his little brother's back. The doctor had told them he would call tomorrow with referral information. It was going to be a long night.

**To Be Continued**

Well, that's chapter one. I hope you liked it. I'll post again soon. Thanks for reading, I appreciate it!


	2. Shadow and Light

Disclaimer: refer to chapter one

**NOTE TO READERS: **I'm hoping to post a chapter every weekend. This chapter is around nine pages long. I wanted to say thanks for the reviews! I'm glad you enjoyed chapter one. Here's chapter two! Happy Reading, I hope.

**So Long, Good-Bye**

**Chapter Two: Shadow and Light**

"…_The truth is gonna change everything. So, lie to me and tell me that it's gonna be alright. So, lie to me and tell me that we'll make it through the night. I don't mind if you wait before you tear me apart. Look me in the eye, lie…"_Lyric excerpt by David Cook, _Lie_

**Eight Days Later, January 10, 2006, Rapid City Regional Hospital, South Dakota**

"Dean you're pacing," Sam said quietly. Dean stopped and pivoted toward his brother.

"I gotta do something Sammy," Dean huffed in frustration.

"The doctor will be in later he already said," Sam answered easily as he smoothed the sheet down around him. He hated hospital beds and especially the gowns.

"We've been here a week Sammy and nobody knows what's wrong with you," Dean paced back to the window and looked down on the parking lot from the eighth floor.

"They're just being thorough," Sam suggested. "You know when Bobby gets back from getting coffee and sees you pacing he's gonna chew you out. It drives him just as crazy as it does me," Sam said with a lopsided grin. He was trying to take away some of his big brother's stress. Dean offered him a tentative smile.

"Thorough," Dean huffed. "They don't know what's wrong Sam … all they know is something isn't right but they don't know what it is. You can hardly cross a room without needing help Sam … your balance is for crap," Dean's eyes were part agonized and part angry. "How can you be so calm?" Sam shrugged.

"Who said I was?" he offered lightly as he stared at his hands. Dean stopped and looked at his brother. Sam looked fragile sitting in the hospital bed.

"Sammy," Dean's voice was quiet, gentle as he approached his little brother. He placed a hand lightly on top of the blanket and grasped his brother's left knee. "I don't want you to worry, okay? They're gonna fix you up and then we're taking a vacation, all right? How about South Beach? I'm so sick of snow and cold weather I could hurl," Dean smiled at his brother. Sam smiled back.

"Sounds good."

"Sammy?"

"Yeah?"

"I was thinking it might be time to call Dad," he said quickly rushing the words out before his sibling could stop him mid-sentence.

"No," Sam replied flatly.

"Sam, this is something he should know about. Hell, remember how ticked he was when we didn't call him about your visions?"

"There's nothing to tell him," Sam suggested. "He didn't call me back when I called him when you got fried and had a heart attack and was dying," Sam's voice held a bitter edge to it.

"Yeah, I know, but…"

"No, Dean, stop giving the man every excuse in the book. We don't know anything, so what is there to tell him, huh? Nothing, so leave it alone." Dean turned back toward the window and was silent. "_Damn_," Sam said under his breath and Dean turned quickly.

"What? What is it?" He was already moving toward his little brother at the statement and the look on his face.

"I gotta take a leak," Sam huffed in impatience and humiliation.

"No problem," Dean answered easily. He knew Sam hated the help. He helped Sam out of the bed and supported him to the small bathroom in his room. He was thankful for the private room. "You okay from here?" Dean kept his voice light. Sam nodded without looking at his brother. "Just hang onto the grasp bars on the wall Sammy for your balance. I'll be right outside the door."

**Two Hours Later, Sam's Room**

"Well, Sam," Dr. Finley began. "You've been pretty patient with all the poking and prodding we've put you through. I've been touching base with your diagnostic team. Dr. Kelts ruled out any neuro-opthamology problems for your blurry vision. Dr. Cwach ruled out epilepsy and EEG irregularities. Plus, Dr. Tibeau has ruled out any strong evidence of neuro sleep problems that would explain your transient sleep pattern problems and he can't pinpoint a neuromuscular problem to explain the mobility issues."

"Okay, so you've said what isn't wrong but I haven't heard anything telling me what is wrong with my brother," Dean huffed. "He's been in this hospital for a week and you still don't have a clue, right? We were sent here for help." The doctor understood the impatience but had to admit he was pretty frustrated himself.

"I've put out a call to a good friend and colleague of mine in Baltimore at _Johns Hopkins_. I've forwarded the tests we've run so far. We've narrowed it down to a definite neurological based problem, but what exactly we haven't been able to ascertain."

"What's this new doc do?" Dean asked as his eyes shifted from his quiet brother back to the doctor's face.

"It's a neurology collective of sorts," Dr. Finley began. "My colleague is the head of a neurology research group and they have been doing some advanced research in many areas, so I'm hoping they will advise us on how to proceed."

"When do you expect word?" Bobby asked easily. He hadn't felt right letting the boys go through this alone especially since John was MIA and Sam was adamant that John not be contacted.

"I'm hoping later today. They are presented with quite a few hard to diagnose cases every month and they can't take them all but I'm hopeful they will be able to advise us on Sam's case. Sam, I have a couple pages of forms for you to fill out," the doctor smiled at Sam rolling his eyes. "I know we've had you do a lot, but they're short, I promise."

**Ten Minutes Later**

Dean and Bobby were outside Sam's room talking to the doctor. Sam was busy with the forms while Dean kept pumping the doctor for more information. "So, this doctor, who is he? Is he good?"

"She," the doctor offered evenly. "And, yes, Dr. Litvan is an excellent neurologist and her team is top notch. They deal in more obscure and hard to diagnose cases, so they are more apt to pinpoint what Sam's problem may or may not be. Worse case scenario they can at least give us some ideas to point us in the right direction." Dean felt a cold heaviness settle in his gut.

"Look doc, my brother's twenty-two and can hardly walk to the bathroom on his own; you can fix this, right?"

"I'm not giving up Dean, somewhere there has to be a diagnosis."

"How does he go from healthy as a horse to this … it just happened," Dean lamented. "No warning," and then it clicked and Dean felt the bile rise. Words uttered by an evil entity over three months ago rang loudly in Dean's head, _I take your days, your life …_ No, this was a medical problem not some supernatural sickness, Sammy was legitimately ill even the doctors agreed, and it was a neurological problem. Then the memory hit, the entity had grabbed Sam's head, rendered him unconscious for a short moment or so. Dean shook his head absently.

"Dean? You okay?" Bobby placed a hand on his shoulder. The young hunter snapped out of his unpleasant epiphany. He looked up and saw two sets of concerned eyes watching him.

"Huh?"

"Are you alright Dean?" Dr. Finley surveyed the young man closely.

"Yeah, I-I was just thinking, sorry…" Dean offered. He had the sudden urge to see his little brother. "Um, I'm gonna go see Sam, okay?" Bobby nodded.

"I'll just be a minute Dean," Bobby assured. "I wanted to ask the doctor a couple things." Dean nodded. The eldest Winchester child entered his brother's room and stopped halfway across the floor. Sam's cheeks were wet with cascading tears as he stared at the forms on the clipboard.

"Sammy?" he spoke softly. "Hey, they're just forms," he offered. Sam looked at him with anguished eyes. "Hey, don't get so worked up. It's just some stuff for a couple more tests," Dean offered. Sam shook his head and handed the forms to his brother. Dean stared at the forms for a long moment. They were filled out all right but Dean couldn't make out hardly anything. Sam hadn't even been able to make his name legible. Dean might not have even figured out it was his brother's name if it hadn't been scratched into the name area on the form. Dean's gut clenched violently. His handwriting had declined drastically in the week since Sam had been admitted. "It's okay Sammy," Dean assured trying to not let his voice shake. "I'll just go get some extra copies and we'll do this together," Dean tried to soothe. He reached up and gently wiped away his brother's tears. "It's gonna be okay," he encouraged with a smile. "I'll be right back." Sam nodded.

Dean had to fight the urge to run from the room to the doctor but he forced himself to walk calmly out. He spotted Bobby and Dr. Finley.

**Five Minutes Later**

"What the hell is happening to him?" Dean hissed under his breath. "Look he never had fantastic penmanship but this …" Dean stared at the forms he had given over to the doctor. "He can't even write his own name well enough to read it. That kid wrote his name in kindergarten better than this."

"I'll forward the new development to Dr. Litvan."

"Forward! Look dammit," Dean was pissed. "His writing was getting bad now and again before he got here, but at least when he was admitted he could fill out his own forms, now look at it."

"We're doing everything we can." Dean turned away frustrated.

"Bobby I gotta talk to you and I don't want to leave Sam alone. He's already torn up enough over this…"

"I'll leave you two alone. I'll be back later," Dr, Finley assured. Dean offered a tight nod and pulled Bobby away. He stopped short of Sam's room.

"Bobby I think this might be because of that entity, maybe…" Bobby's mind searched for the memory of Dean telling him about his and Sam's hunt before they came to his house for Thanksgiving.

"The one that grabbed Sam's head and said that crap as you banished it?"

"Yeah, you think…"

"It's possible, but…" Dean knew what was on the older hunter's mind because it was on his, too.

"But, what ever it did is causing a natural problem not supernatural, right? There has to be something," Dean lamented.

"There is … we get him help from this new doctor. We're going to get this done Dean but in the mean time I'm going to call up some friends and see if I can get us a supernatural fix, too." Dean smiled.

**One Hour Later, Sam's Room**

"You don't have to fill the form out Sammy just read it and tell me what to fill in, okay?" Dean urged. "Is your eyesight too blurry?" Sam shook his head and scrunched his forehead in frustration and lifted the paper upward. Dean watched the perplexing movement and finally stood up. "Sam what are you doing kiddo?"

"I can't …" Sam started and stopped. He tried lowering the paper and reading it again and he couldn't make his eyes look down, it was as if he had little to no voluntary control to make them look down to read the damnable piece of paper.

"Can't what?"

"Look down Dean," Sam looked at his big brother and there was an edge of fear in his eyes.

"What? What you mean you can't look down? Just look down," he urged.

"I can bend my head Dean, but you're not getting it, I can't make my eyes look down," Sam paused. "Dean what's wrong with me?"

"It's gonna be okay Sammy," Dean squeezed his brother's shoulder. "Let me go get the doc, okay? I'll be just outside. It's gonna be alright."

**Two Hours Later**

Sam had been given a light sedative and was sleeping peacefully. "I thought you said the doctor that specialized in eye stuff said there wasn't a problem," Dean huffed. Bobby stood nearby.

"He could not find a cause for the blurry vision or this new eye movement problem. There isn't a blatant neurological problem that is screaming at us Dean. There is an obvious problem but we just don't know what it is, yet."

"What about this doctor in Baltimore?"

"They accepted Sam's case and the PET scan we completed earlier has already been forwarded to Dr. Litvan and her team."

"And, what about his new eye trouble does she know?"

"Yes, that new information was forwarded with the PET scan over an hour ago. She will be in contact when they have had a chance to look over all of the tests results and previous scans I emailed to her." Dean blew out a frustrated breath.

"I'm gonna go sit with Sam." He left with no further preamble and Bobby stepped forward.

"Dr. Finley?"

"Yes?"

"Do you think this Dr. Litvan and her team can help Sam?"

"I think they are Sam's best shot at a solid diagnosis. They really do have a vast knowledge base of a plethora of brain disorders and diseases," the doctor assured. Bobby simply offered a solemn nod.

"I'm going to go be with the boys," he replied. "If you hear anything…"

"I'll let you know the moment I hear something, but it could be a few days Mr. Singer." Bobby nodded once more and turned to go be with Dean and Sam. His mind troubled with the fact John had not been called yet but so far Dean had abided by his little brother's request for their father not to be called and he wasn't going to overstep. He knew it was a matter of time before Dean called his father and told him about Sam.

**Meanwhile, Four Days Later, Baltimore, Maryland**

"Irene, we've looked over everything pertaining to Sam Collins and it's the only thing that fits completely," Dr. Tim Hain replied. Dr. Litvan looked at Tim and the members of her diagnostic team.

"Do you all agree with Tim?" They nodded.

"He's the youngest onset case we've ever come across," Dr. Lee Goldman commented as he flipped through the various test results and scans. "The youngest onset I've ever heard of was a 35 year old with beginning stages and it took him almost three years before he started showing more advance symptoms. He had almost nine years before it was over."

"I know he's the youngest onset case we have on the books," Irene Litvan replied. "I've never seen it come on so aggressively. It appears he's already coming into phase 2 of the disease."

"Yeah," Nicole Mallory broke into the conversation. "I'm looking at these notations and it looks like he presented at the beginning of the year on New Years but according to this his brother noticed the vision and hand writing problems a month before he and their uncle noticed some additional onset issues around Thanksgiving. This sucker is moving fast at this rate …"

"I know he may be incapacitated in a couple months or so if it doesn't plateau out soon," Tim Hain agreed.

"Alright, then we're agreed," Dr. Litvan commented. "I know the doctor currently caring for Sam. I'll forward our diagnosis to him and I'm going to catch a plane out to South Dakota to talk to the family personally."

"Do you think we might get them to come to Baltimore for further examination? I mean, it's so rare for someone as young as Sam Collins is to get this," Dr. Hain spoke evenly. "I mean I'm used to maybe 50 year olds showing signs but this kid is only 22," he looked at some paperwork as he spoke Sam's age, "He'll be 23 in May …"

"Well, apparently this disease isn't as age specific as we once thought and I've spoken to Robert … Dr. Finley, the physician that is caring for Sam, the family seems pretty set on staying in South Dakota since their uncle lives nearby. We can't offer them a cure and I won't suggest he become some lab rat for us to examine for medical posterity," Irene understood the medical significance of this case but she also understood what was coming for Sam and his family and she wouldn't add to the tragedy. She'd keep track of his case but wouldn't uproot him and his family for empty hope.

"Yeah, you're right," Dr. Hain lamented. "We'll just keep tabs long distance and record the data as we get it. I wouldn't want to put the kid through more exams that aren't going to do anything for him."

"I'll go make the call."

Dr. Litvan left the room and walked to her office. She sat down with a heavy sigh. This was the part of her job she hated. There was no hope, no cure and he was too young. She silently wished there could have been some other prognosis, some other diagnosis, but it was unavoidable and everything pointed to it, it was a textbook case and she knew with a cold certainty she and her diagnostic team were correct in their diagnosis. She picked up the phone and dialed.

**Meanwhile, Dr. Robert Finley's Office, Rapid City, South Dakota**

He sat updating some charts from his rounds as his phone rang. "Hello, Dr. Finley speaking."

"Robert?"

"Irene," he knew that voice quickly. "It's good to hear from you. Has there been any progress in coming to a diagnosis for Sam Collins?"

"Yes," her voice was solemn.

"How bad?"

"Rob, we're positive it's PSP."

"What?!" he barked. "He's only 22; I thought that hit 60 year olds. We didn't even consider…"

"You did everything right Rob," she assured. "There was no reason in the world to ever even consider PSP, but there's no mistaking it. We're positive. Until Sam the youngest patient was 35 with early onset but Sam's onset is the most aggressive we've seen based on his rate of symptoms from onset."

"Jesus," Dr. Finley blew out a breath. "Dammit the kid is 22 and this is what I have to tell him and his family. At the rate it's hitting him if it doesn't slow …"

"I know," Irene agreed. "We discussed that and we feel that if his symptoms which clearly are encroaching into the beginning of phase 2 don't slow down he could be incapacitated in a couple months … maybe less, maybe more," she hedged. "I'm faxing some information sheets for the family but I'm catching a plane out tomorrow and would like to counsel Sam and his family personally, but only if that's okay with you."

"Okay? Of course, it's okay. You've dealt more with this than I have. Hell, I only ever read about it in the books and some journals. They need to know what's coming and I can only give the basics."

"Okay then, I'll get a flight out tomorrow morning and should be there late morning or early afternoon, okay?"

"Thanks Irene," Robert replied easily.

"You're welcome Rob. I just wish it were better news. The family and patient info packet is faxing right now," she said.

"Yep, I hear the fax. Hey, call or email your flight info and I'll have a hospital concierge come to get you at the airport, all right?"

"Certainly, see you tomorrow."

**A Short while Later**

Dr. Finley xeroxed the packet two more times and stapled it. He rubbed a hand over his tired eyes. He had read over the packet himself and the clinical sheet Irene had written his name on top of … he sighed and stared at his patients file and he wrote with heavy heart into Sam's file: _patient has been diagnosed with Progressive Supranuclear Palsy (PSP). Rare early onset at 22 years old. The case has been determined to be of an aggressive nature and findings suggest that the patient has entered into the early stages of phase 2 in the disease process_. _I will inform patient and family of the diagnosis and Dr. Irene Litvan will provide addition family consult on this case._

He closed the file and picked it and the packets up; he wanted Sam, Dean and their uncle to have one to read over. He walked slowly back to the neurology unit where Sam was located. Some days he hated being a doctor.

**To Be Continued**


	3. Gloaming

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks for the reviews! This chapter is around 8 pages long. I wasn't sure I would be able to get this chapter finished and ready for you this week. I lost my Mom on January 21, one day before my birthday and this has been a very hard week to say the least. So, I hope you'll understand if chapter 4 takes a couple weeks to be posted. My plate is so very full right now but I will keep posting, I promise. I just need some extra time. I hope you all understand. Happy Reading!

**So Long, Good-Bye**

**Chapter Three: Gloaming**

"…_It's the truth that I don't want to hear. You're hiding regret in your smile. There's a storm in your eyes that's been passing for awhile. Hold on to the past tense tonight. Don't say a word; I'm okay with the quiet…"_ Lyrics by David Cook, _Lies_

**Rapid City Regional Hospital, Courtyard**

Dean was thankful for the cold weather because he had the entire courtyard to himself. He felt numb and not just from the chilly temperature … this was a numbness born from fear and helplessness to help his brother. He sat on a wood bench he had brushed the snow from and stared at the packet of information he'd already read twice. Dr. Finley had spoken to him, Sam and Bobby over two hours ago and had told them of the diagnosis. He read the list of potential problems. Sammy was in the beginnings of phase 2 and there were only 4. Dean lamented over what was to come and knowing that there was no fix for this. Bobby hadn't turned up any solutions and it appeared that the entity had made good on his decree before it was banished and destroyed. This disease would take Sam's days, and eventually his life.

The litany of possible phases and stages of the disease made Dean's eyes burn with unshed tears. His little brother would essentially lose most of if not all of himself before this disease claimed him. Dr. Finley had said Sam may not experience every symptom or complication, but nonetheless it was apparent he was facing an aggressive form of PSP. Dean stared at the paper list again noting that some things had already come to pass. The paper shook slightly as Dean read it yet again:

The Phases/Stages of PSP

_Phase 1__ - Deterioration of handwriting and difficulty writing. Speech problems, difficulty being understood by others, slurring, etc. Coordination problems leading to unexpected falls and stumbling; change in walking rhythms/patterns. Vision problems; some complain of 'blurred' vision; some try prisms, but examinations by eye Dr. generally will only find normal vision physically. Lethargy, apathy, no desire to do anything; changes in sleep patterns._ One thing that bothered Dean was what if Sam experienced a _decrease of sound judgment_ at some point would he then have to override his little brother's thoughts and wishes to make sure his kid brother got the treatment he needed. Dean knew Sam already felt helpless enough he only hoped that he wouldn't have to take Sam's decision making from him, too.

_Phase 2__ - Problems sitting down or getting up; cannot lower self into chair gently; just 'plops' down. Increased difficulty walking; begins using a cane for balance; will progress to a walker; increased number of falls. Stooped posture because of vision problems; can't see downward easily. Problems opening or closing eyes; some patients get 'dry eye' because their eyes do not close all the way. Difficulty dressing; cannot do buttons or zippers; hands and fingers do not work as they used to. Almost impossible to write anything legibly. Eating problems; coughing and choking; loss of eating etiquette; fills mouth too full; lots of spills; begins wearing a bib to save clothes. Bathroom problems; difficulty voiding/unable to get to bathroom in time; constipation or diarrhea; may need help with personal hygiene. Needs help bathing; may need hand rails/bathing bench, etc. A mobile shower head is a good idea, if possible. Weakness or neglect on one side of body; one side more dominant; ie: drags left or right foot, etc. (Shydragger syndrome) Subject to infections; urinary tract, respiratory tract (pneumonia) etc.  
Alien hand; sometimes holds on to things and cannot let go or takes the hand a long time to release. Difficulty concentrating; sometimes seems 'out of it'._

_Phase 3__ - Some obsessive-compulsive behavior: ie: fingers "pill rolling", hands smoothing out imaginary wrinkles on table, etc. Increased irritability; increased impatience. May become incontinent of urine and bowel. Increased speech problems; often very difficult to understand; cannot articulate proper speech sounds. Increased eating problems; more coughing/choking. Increased cognitive problems; cannot follow stories on TV; cannot read much, due to vision; will watch game shows, some news. In Theater movies are not recommended, as some suffer from 'sensory overload'; loud sounds and many colors, lots of movement on screen make patient 'nervous'. sleeps much of the day, and all night, too. Instances of 'restless leg' syndrome. Limbs and neck may become rigid; may loose ability to support self on legs. Increased falls; some falls may be close to being described as 'seizures'; complete loss of control of arms and legs, with resultant fall. After fall, will sleep for an hour or so; may not always know whether is injured or not; may not 'feel' the injury. Increased coughing and choking; drooling becomes common; often does not close mouth; Infections may be more frequent. Requires much more help in dressing and with all activities of daily living. Does not speak much, but does enjoy seeing friends and relatives, even though patient may not respond much to them. May have pain in arms or legs; non-specific pain for no apparent reason; application of 'heat' rubs may help; Tylenol may also help._

_Phase 4__ - Unintelligible speech/mumbling; cannot say words; may go days with out saying anything, constant drooling; coughing and choking may become so severe that eating normally is impossible; Dr. may recommend feeding tube, which requires a surgical procedure to install. May have trouble opening mouth, even for meds. Increased incontinence/constipation problems. Loosing interest in daily activities; sleeps most of the time; uncomfortable sitting for any length of time; prefers bed. Cannot support self on legs; 'spaghetti legs'; body rigid, especially neck area. Little eye movement; cannot 'look' at something; slow to focus on things in view. delusions, hallucinations at times; may be disoriented and not know where they are. Pain, but cannot identify the area. Withdrawn, but remains aware of people; cannot move on own; needs extensive help for all activities of daily living. The main causes of death for a PSP patient are infections and breathing problems._

_Note:__ These phases or categories often overlap and are not the same for all patients. Some may have two or three phase 1 problems and one phase 3 problem. Some may never have all of the problems, but most will need extensive help to live out their lives and will need to be made as comfortable as possible for the duration of their illness. It is wise to gain from the patient, specific information as to feeding tubes, restorative therapies, etc. before the disease is well advanced; a living will is a good idea, so that loved ones will know how the patient wishes to be treated, should life threatening acute problems occur. Long term care will probably be needed and plans should be made before the patient becomes unable to participate in the planning._

He finished reading the layperson handout and he angrily wiped at the hot tears cascading down his cheeks. He wanted to go back to Sam's room, but his brother had quietly asked to be left alone for a while and Dean couldn't deny him the request, although he ached to see his brother and to try and comfort him anyway he could. He was Sam's big brother and it angered him that he couldn't fight this for his sibling; he wished desperately that he could take on this burden for his kid brother but it wasn't to be. His finger absently traced the statement toward the end of the paper _a living will is a good idea, so that loved ones will know how the patient wishes to be treated, should life threatening acute problems occur_. Dr. Finley had said that Dr. Litvan would be arriving tomorrow to counsel them on the disease more thoroughly and Dean simply wanted to pack his brother up in the Impala and hit the open road and leave this nightmare behind them … _you can wish in one hand and crap in the other and see which one fills up first_, he thought bitterly to himself.

There was no avoiding this and Dean was scared but he drew in a long breath and blew it out. He knew if he was scared his brother was absolutely terrified. He looked at his watch and decided that almost three hours was enough space. He considered calling his Dad but would hold off until they talked to Dr. Litvan, plus he felt as if he were going against Sam's wishes and for the moment it was the one thing he could do for Sam … not bring their Dad into an already stressful situation until Sam was ready. He knew Bobby was taking some time too and he had said he was going to call some more of his contacts in an attempt to find some fix. Dean knew there wouldn't be a fix for this though and that simple truth left him stripped bare. Dean stood up and brushed the remnants of snow off his jeans and turned to go back inside. He needed to see Sam.

**A Few Minutes Later, Sam's Room**

Dean approached his brother's room and saw his day nurse Mindy leaving. "Everything okay?" He looked at her with concern in his eyes. He saw the curtain was pulled near Sam's door to offer him more privacy.

"Dr. Finley prescribed something for anxiety and to help him get some sleep. He felt Sam was a little overwhelmed and needed some rest. He's sleeping," she assured. Dean nodded.

"Thanks," was his simple answer. "Um, if our uncle comes up here, tell him it's okay to come in, okay?"

"Will do," Mindy assured. "If Sam wakes and needs anything let me know." Dean offered a soft smile and a quick nod and quietly entered his brother's room. He stood there watching his little brother sleep.

"We're gonna get through this Sammy, okay?" he said quietly. "You're not alone," he assured as he swallowed the lump in his throat. He reached down and gently pushed back his brother's long bangs. Sam moved slightly in sleep and settled under his brother's gentle touch. "I'm here little brother."

**One Hour Later, Sam's Room**

"You've lost your damn mind," Dean barked.

"Dean, a facility…" Sam started.

"No, dammit, we're gonna beat this …"

"Come on Dean wake up," Sam's voice was tight. "Bobby said he can't find anything to fix this."

"Sam," Bobby pushed off the wall he was leaning against. "I won't stop trying." Sam offered soft knowing smile at the older hunter.

"I know but face it Bobby you and I both know that whatever that entity did to me is the real deal … there's no fix. And, Dean you know how this story's gonna end man, we just haven't got to the last page yet."

"No, hell no," Dean blurted. "There's gotta be some treatment and pill or something, we…"

"We aren't going to do anything Dean," Sam's voice cracked. "I'm the one that's going to end up pissing himself; eating through a tube … I won't even be able to bathe myself." Dean looked at his brother and couldn't hide the agonized look.

"Sammy…" Dean couldn't find more words to make it past the lump in his throat. Bobby looked between the two boys he loved as if they were his own.

"Okay, boys here's how it's gonna work," he started and both Sam and Dean shifted eyes at Bobby's strong tone. "Sam we still haven't spoken to this Dr. Litvan yet, so we'll see what she has to say," Bobby held up a hand when he saw Sam about to protest. "Look, she may just have the same information to tell us that these brochures did, but she can answer questions on what we need to do to make this work. I want to see if she can recommend a doctor near my house, so we can take you back to my place. You're not going to some facility Sam."

"Bobby, no," Sam started. "You read the same material I did. Eventually I'm going to need around the clock care; I can't do that to …"

"Sammy, don't talk like that…" Dean turned away and looked out the window.

"Why? It's the truth," Sam stated bluntly. "What? You gonna bathe me, change a diaper?" Dean turned then.

"I've done it before." Sam blew out a breath.

"Yeah, Dean, the last diaper you changed I was two and half and you stopped bathing me when I was six. I'm twenty-two man and I can't let you …"

"Yes, you can. We're family," Dean asserted. "Look it's not going to come to that, alright? We're going to get this done and you're going to be fine."

"Dean, you're not hearing me," Sam's voice cracked then and Dean saw his little brother's eyes well with unshed tears. "I just can't have my older brother doing this, it's humiliating…"

"So, you'd rather a stranger …" Sam cut him off.

"Yes, when it comes to doing some of the stuff that's coming my way, yeah."

"Okay, boys let's not jump from A to Z," Bobby propositioned. "How about we work on A for a bit longer and then try B, okay? Let's just slow this runaway train down a little."

Sam and Dean seemed to understand the request and they both relented giving Bobby a slight nod. Bobby smiled.

**The Next Day, Mid-Morning, Sam's Room**

"So, when will I need help taking care of myself?" Sam's voice was quiet. He looked at Dr. Litvan. She had arrived earlier in the morning and had been talking to them about PSP and much to Sam, Dean and Bobby's chagrin she hadn't painted a picture any different that the one they had read about.

"Sam, it's hard to say. I've never seen a case of PSP as aggressive as yours nor have any of my colleagues. "As we've touched on already, you may skip some symptoms all together, but you should be prepared for the future," she paused. "Normally, I'd be talking to you about years before the disease claims you and you could make long-term care plans, but your case is different. I can't really say when you'll need the twenty-four hour care that late stage PSP patients require. You're still able to swallow and eat, so as yet you are not experiencing any of the issues that frequently require feeding tubes and as you know by our discussion and the material you've read … that often the cause of death for PSP patients is aspiration pneumonia or some other infection. However, in my experience it is usually aspiration related infections of the lungs."

"But, we can prevent that right?" Dean sounded off. "I mean if he starts having trouble a tube will keep that from happening, right?"

"A feeding tube would solve any issues of him choking while eating, but Dean, this disease isn't kind hearted. Even if we were able to protect him from aspiration there is always the chance of some other infection claiming his life in the end stages and at the end …" Sam spoke up softly again.

"So, at the end I won't be able to communicate at all?"

"We know that PSP patients are aware of a lot and unfortunately the ability to communicate becomes less and less as the disease progresses and you'll become more withdrawn from those around you. However, it is in my experience that even as withdrawn and uncommunicative a PSP patient may be at the end they are aware their loved ones are nearby and are comforted. Sam, I wish I had a solution to help you but the disease is moving quickly."

"What about medications to help?" Bobby spoke up now.

"There has been only very limited successes in improving some symptoms with the use of medications we commonly prescribe for Parkinson's patients but the outcomes have always been limited, and short-lived. I won't be putting Sam on these medications at this stage. We sometimes prescribe some antidepressants but again they have only slightly improved symptoms but have been successful in addressing patient depressions."

"No pills," Sam spoke evenly.

"Sammy, maybe…" Dean's eyes were desperate.

"No, pills," Sam asserted. "You said I may not experience every symptom I read about, so does that mean I might still be able to talk, maybe not have swallowing problems."

"Unfortunately Sam," Dr. Litvan began with sad eyes. "Those symptoms seem to be universal among all PSP patients for the most part."

"When can we take him home?" Bobby asked quickly. Dr. Finley stepped forward.

"I'd be prepared to release him in a couple days provided there are things in place to handle what is coming. I can make some calls to a local physician near your home and start making arrangements in advance."

"No," Sam spoke up. "I'm not going to have them taking care of me. I can still get around with a little help. I'm not a kid."

"Sammy, that's not what he's saying man, he just wants to make sure that _if_ we need some extra help it'll be there."

"_If_?" Sam gave his brother an incredulous look. "You're kidding yourself Dean. There is no 'if' I need it but when I need it and if you're thinking I'm getting better from this you're lying to yourself. It's time to come back Fantasy Land." Sam's voice was bitter.

Dean stood stock still and his silence spoke volumes to the room but they all knew Dean's last vestige of hope had just evaporated. He took a breath.

"Okay, fine," he started evenly. "We go home we get someone who can help out when it's needed, but only when it gets to the point you don't want us doing it, how about that?"

"Only if you and Bobby agree not to give me any crap when it's time to …"

"To what? Put you in a fucking home?" Dean spat.

"Dean," Bobby's voice was soft as he tried to remind the young hunter they weren't alone in the room. Dean curtailed his tongue.

"You're not going in any home Sam."

"I won't go unless you agree when it gets too advanced, we find a place for me." Dean's face looked agonized.

"Dean," Dr. Litvan began. "Sam's making a very difficult decision but he's right. PSP patients require a lot of care especially toward the end and quite frankly a facility with trained medical professionals may be what is required near the end."

"The end?" Dean knew that PSP was a death sentence and that his brother's version of the disease was progressing quickly but to here it so bluntly made his gut clench.

"How long?" Sam asked as he looked into the doctor's eyes.

"It's hard to say Sam," Dr. Litvan answered. "You're clearly showing signs of phase two symptoms and you may very well show some more before phase three. It's still moving quickly … maybe two or three months, but it could be longer or shorter depending on the disease process, but it is aggressive, Sam. I'm sorry." Sam nodded and dropped his eyes.

Sam looked at his brother and Bobby. "Do you promise?" Dean and Bobby both looked troubled but they nodded to Sam. The young hunter then looked at his physician "Dr. Finley," Sam spoke after a long moment of silence had fallen across the room. "Can you make the calls? I'd like to go back to my uncle's."

Dean reached out and dropped his hand gently on his brother's forearm and offered a comforting squeeze.

"Yeah, doc, we'd like to take him home," Dean's voice was tight with emotion.

"I'll start making calls today," Dr. Finley replied.

The two hunters knew that there was a battle coming and Dean and Bobby felt helpless to save Sam, but they wouldn't stop trying. _There has to be a way, right? _Both of their minds holding that one sentiment.

**To Be Continued**

I hope to update again soon, but as I wrote in my "Reader Note" at the start of this chapter. I just lost my Mom this week and frankly I'm surprised I was even able to finish this chapter and get it out to you this weekend. So, please be patient if it takes a couple weeks for chapter 4 to be ready. Thanks again for reading and I hope you're still enjoying the story.


	4. Persistence of Normal

Disclaimer: refer to chapter one

**NOTE TO READERS: **I wanted to thank everyone that sent me very kind condolences over the recent loss of my mother. They are much appreciated. Also, thank you for the reviews that I received. I thank you for your patience in this newest chapter. I know it's been a while since I last posted. This chapter is around 7 pages long and I hope it's a good read. Things are still pretty up in the air for me now, but I will try to post again next weekend at some point. Thanks again for everything! Happy Reading, I hope.

**So Long, Good-Bye**

**Chapter Four: Persistence of Normal**

"… _I know he's living in hell every single day, and so I ask oh God is there some way for me to take his place … when all you know seems so far away and everything is temporary, rest your head, I'm permanent …"_ Lyric excerpt by David Cook, _Permanent_

**Three Weeks Later, Bobby's House**

Dean stood in the doorway to the library, or what used to be the library. Bobby had moved many of the books out only keeping those on shelves in the room. Sam liked being around the books even if he couldn't read them anymore. The library had been made into Sam's room now. Dean watched the early afternoon light cast across his brother as he slept. Bobby had arranged with Dr. Finley's help long distance with another doctor nearby to have a hospital bed delivered for Sam a week ago when Sam could no longer get up the stairs to his bedroom he shared with Dean even with help. Dean felt a hand land gently on his shoulder and squeeze.

"It's happening so fast Bobby," Dean whispered. "He can hardly walk now."

"The rolling walker is still keeping him mobile," Bobby encouraged. "He can still talk, he's just having more mobility problems but we're still handling things. We haven't had to get a nurse yet, just a visiting one to check on him between doctor visits in town. He's holding his own Dean. He hasn't developed any new symptoms."

"Yet," Dean lamented. "But his eyesight is crap now. He can't read anything, he can't write unless it's one word at a time and even that looks like a chicken scratch. You're right about his mobility. I want to help him Bobby but I don't know how."

"You are boy," Bobby tried to comfort. "You're here for him."

"It's not enough."

"Dean," Bobby's voice was plaintive. "You call your daddy yet?" Dean nodded.

"Sam was pissed," Dean answered flatly.

"You get a hold of him?"

"Just his voice mail … I left a message."

"Did you tell him about Sam?"

"I can't leave that kind of message," Dean's eyes were agonized. "I told him something was wrong and that he needed to call me back as soon as possible. I told him we were staying with you."

"Dean you need to tell him about Sam…"

"I shouldn't have to tell him," Dean looked at his sleeping brother once more and stalked off toward the kitchen. "He shouldn't have to hear the whole story for him to call me back. I tell him something is wrong and he needs to call ASAP, he should dammit!"

"Dean, son, you know your daddy," Bobby commented. "He can be pretty single minded. You should tell him the whole story even if it is to his voice mail." Dean looked at the older hunter, "at least consider it, okay?" Dean nodded.

"I need to fix Sam some lunch."

"Still no swallowing problems that's good news," Bobby offered up something positive for the bleak situation. Dean offered a small smile that didn't reach his eyes.

**Thirty Minutes Later**

Sam sat in the bed and ate the chicken noodle soup and reached to dip some fresh corn bread into it as he looked over at Dean. "You okay?" Sam asked in an even voice.

"Yeah," Dean replied a little flat. He offered up a small smile. "How you feelin' Sammy? The soup good?"

"It's good Dean. The chicken tastes pretty good in it."

"Well, you can thank Bobby for that he made some chicken breast and suggested I add the chicken to the noodle soup. You should eat more Sammy, you need it."

"This is enough. It's not like I'm burnin' a lot of calories Dean scootin' back and forth to the can."

"Sammy," Dean's voice was soft.

"Don't, okay? I don't want to have this conversation again." Dean nodded. Sam spooned a helping of the soup into his mouth and jerked forward as he swallowed. He coughed loudly. Dean was out of his seat in an instant.

"Sam!" Dean put a hand on his brother's back as Sam coughed. Sam attempted to wave him off and finally forced out between coughs.

"I'm fine … just … went down the wrong pipe," he assured. Dean pulled his hand off of his brother's back and couldn't miss how badly it was shaking. He balled his fist up a moment to try and quell his shaking. Bobby came into the room quickly.

"What's wrong?" his eyes went from one boy to the other. "Sam you okay?"

"Fine, just swallowed the soup wrong," he tried to assure. "It's my own fault anyway, leaning back while trying to eat soup. Everything's fine." Dean didn't say anything but he reached for the plate that balanced the bowl and the corn bread. "I'm still eating," Sam put his hand on the corner of the plate to stop his older brother from taking the food.

"But," Dean couldn't formulate what he wanted to say, what he feared was that this was a sign of a new symptom. Sam just looked at him and Dean released his hold on the plate. "Bobby why don't you sit a shoot the breeze with Sammy," he stated keeping his voice light. "I'm gonna grab a beer." He left the room quickly. Sam and Bobby watched Dean leave the room.

"He's just worried Sam," Bobby offered quietly.

"I know," Sam's voice was sad. "I just swallowed wrong Bobby, it could happen to anybody," Sam tried to assure not only Bobby but himself, too.

**Three Days Later, Greene Memorial Hospital, Outpatient Waiting Room**

"Well?" Dean asked quickly as he stood up as Dr. Finley entered. Dean couldn't shake the anxious feeling in his stomach. Sam had experienced more problems swallowing on and off over the last three days and Dr. Finley had agreed that Sam needed a swallowing study to ascertain whether or not Sam was indeed now exhibiting progressive PSP symptoms now involving his ability to properly swallow.

"Hi, guys, you wanna come back," the doctor motioned for them to follow him. Both Dean and Bobby didn't hesitate to follow Sam's doctor.

"How's Sam?" Dean pushed.

"Fine," the doctor assured. "He's down the hall getting out of his gown. The procedure went off without any problems. The swallowing study is complete and there were no complications. Sam will be able to go home today as soon as he has changed."

"Did you get the information you needed during the study procedure," Bobby asked.

"Yes, I've already spoken to Sam. Please," the doctor stopped at a conference room door and motioned for the two men to enter. Dr. Finley looked from Dean to Bobby and back to Dean's intense eyes. "Sam's test was positive for increased Dysphagia, or difficulty in swallowing in layman terms." Dean sat silent, he had known even before the doctor said anything but he had hope, a small ember, and now it had been snuffed out. Bobby leaned forward and placed a hand on Dean's shoulder and squeezed. "I know this isn't what you wanted to hear. I wish I had a better prognosis, I do," Dr. Finley replied with earnest eyes. "This new progressive symptom will put Sam at risk for aspiration…"

"You mean getting it in his lungs," Dean replied quietly as he looked at the doctor. The doctor smiled slightly and nodded.

"Yes, but it isn't so advanced yet that a feeding tube is needed, but his diet will need to change. During the study we have found that liquid and certain consistency's of solid are more actively causing him problems than others. The nutritionist has given her recommendations for food preparations. He'll need things pureed and the pharmacy in the lobby has already received an order from me for some Thick-it powder. The powder will help you firm up liquid food items for Sam and the usage chart is really easy to understand. Also, I will order in for you some Thick-it purees. Here is a list of what is currently available. Dean looked at the brochure from the company:

_Great Flavor to Nourish Your Loved Ones._

_If you or your loved one suffers from dysphagia, you know that getting proper nutrition in an appealing, convenient manner is an everyday struggle. _

_Now, from Thick-It__, the brand you trust for quality instant thickeners, comes Thick-It__ Purees, a new line of great-tasting pureed foods designed with your needs in mind—just open, heat and serve. Choose from thirteen delicious, nutritious favorites, like Beef Stew Puree, Sweet Corn Puree and Maple Cinnamon French Toast Puree, Seasoned Chicken Puree, Chicken a la King, Carrot and Pee Puree, Beef Lasagna Puree, Beef and Barbeque Sauce Puree, Omelet with Sausage and Cheese Puree …_

Dean's eyes looked away when he read 'Omelet with Sausage and Cheese Puree' is this what his little brother's life was being reduced to with this damn disease.

"Dean, I know it isn't easy to look at this stuff and it makes it more real than you're probably wanting right now but Sam's going to need you."

"I know that," Dean's voice was quiet and clearly bitter. "How'd he take the news?" He already knew the answer but he still asked.

"Just as Sam's has taken everything else, he's clearly upset but he's handling it."

"So," Bobby leaned forward injecting himself in the conversation to allow Dean a moment to assimilate the new diagnosis for his brother. "Until the actual food puree stuff comes in what do we do so Sam can eat?"

"There are detailed directions with the Thick-it powder. It will help give some food a consistency that he can swallow with limited difficulty. The dietician suggests and I concur that anything with a consistency of pudding or even a firm baby food puree will work. She has provided a detailed preparation booklet to make some meals for him in the interim that you can use the Thick-it powder with. We can have the Thick-it purees ready for pick-up as soon as tomorrow afternoon if you provide us with an order. I've given Sam the same brochure, perhaps speak with him before leaving and I can place it with the pharmacy and once that order is in we can arrange for the company to deliver to your doorstep directly from the manufacturer. We'll keep tabs on his weight and watch for malnutrition. He may require some additional vitamin supplements, but we'll see." Bobby and Dean nodded.

"I want to see Sam."

"I'll wait for you boys in the waiting room," Bobby stood and walked out with the doctor.

"He's down the hall. Procedure room 4," Dr. Finley replied as he saw Bobby out to the lobby.

**A Few Moments Later**

Dean knocked on the door. "Yeah?" came the quiet voice of his brother.

"It's me Dean."

"You alone?"

"Yeah, dude Bobby's in the lobby waiting on us," Dean shook his head.

"Okay," and Dean took that quiet reply as an invitation to enter. Sam sat on an exam table and was clearly frustrated with his shirt. Dean frowned.

"The nurse didn't help you?" Dean couldn't hide the frustration.

"I told them I could do it," Sam tried to work a button on his shirt again and dropped his hands and smacked the table in anger. "Dammit," he barked under his breath.

"Hey, hey," Dean stepped forward. "It's okay man, here," Dean reached up to help his brother and Sam batted his hand away.

"No," Sam said quietly.

"Sammy, man its okay, let me help."

Sam raised his head and looked at his brother and Dean saw the tears building in his little brother's eyes. "Well, I could let you go out there with your shirt open, give the ladies at the reception desk a thrill for their day, but…." Dean attempted some light humor. "I mean most of the guys they see all day or old dudes with a spare tire in the middle instead of a six-pack."

"Dean…" Sam couldn't suppress a small grin and his cheeks dimpled ever so slightly despite being on the verge of crying.

"Well, I'm just saying kiddo…" Dean grinned back. "So, what do you say?"

"Fine," Sam conceded and allowed his big brother to button his shirt. "No more button shirts Dean."

"Hey, you're the layer dude," he jested. "We'll get some more pull-over shirts, okay?" Sam nodded. "Dr. Finley talked to us," he offered quietly.

"Yeah, I figured."

"So, this new diet," Dean began, "it's gonna be okay. The dietician chick gave us a big booklet with recipes and stuff …"

"Dean, maybe it's time…"

"No," Dean's voice was firm and it brooked no argument. "So," he began quickly changing the subject as he glanced at the Thick-it Puree brochure next to his brother. "I saw they have Caramel flavored Apple Pie Puree, Mmm … pie." He smiled at his little brother as he buttoned the last button. Sam shook his head.

"You've got issues man," he smiled. "We're talking' Pie puree … puree," Sam accentuated the word puree. Dean cocked his head slightly and smiled.

"Yeah, so, it's still pie, man…"

"Like I said … issues…" Sam smiled at his brother and Dean ached at the dimples. "Dr. Finley wanted me to place an order today, so could you …" Sam hesitated.

"What?" Dean pushed gently.

"I can't circle the ones I want … can you?" Dean knew how incredibly hard it had to have been for his brother to say that simple sentence to admit he needed help and especially with a task as simple as circling what he wanted in a brochure. It made the bile threaten to rise in Dean's throat that his brilliant little brother no longer had the ability to circle with any sense of hand control in a brochure. He swallowed the lump in his throat and squeezed his brother's shoulder.

"Sure, Sammy, what sounds good," he smiled and kept his voice light being careful to hide his emotions deep under the surface. He'd be strong for Sam, he had to be, and he would be.

**To Be Continued**


	5. Vespers

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thank you for the reviews and the condolences you all continue to PM and email me, it's appreciated. I'm sorry that I didn't post last weekend, but things are still a bit unsettled, but I wanted to get you something out this weekend, so I really tried. This chapter is around 6 pages long. Again, I'm sorry I haven't been able to post every weekend, but it is what it is, I suppose. Thank you again for your support.

Happy Reading, I hope!

**So Long, Good-Bye**

**Chapter Five: Vespers**

"…_Don't want to believe in this ending. Let the cameras roll on, keep pretending. Tomorrow's all wrong if you walk away, just stay…" _Lyrics excerpt by David Cook_, Lie_

**February 17, 2006, One Week Later, Bobby's**

"Easy Sammy, I got ya," Dean coaxed from behind his little brother. Bobby stepped forward and went up the stairs to his porch.

"I'll get the door," he said as he passed the boys. Sam had had an appointment with the doctor today and had insisted on getting up the stairs on his own steam. He had passed off his walker to Bobby and clung to the wooden railing as he took one slow step at a time up the stairs. Dean walked behind keeping a supportive and protective hand on the small of his sibling's back while the other hand loosely held Sam's left elbow. Sam struggled but kept pushing.

"You don't have to prove anything Sammy," Dean said quietly. Dr. Finley would have Sam take a couple steps to show his mobility among other things and the visits always wiped Sam out.

"I'm nnn …not," Sam stuttered. His speech had been experiencing an occasional difficulty again over the last week. He would have trouble speaking or slurring, but he could still communicate. "Just need to be able to still do ssss…something." Dean nodded.

**Later that Afternoon**

"Okay Sammy," Dean smiled as he entered with Sam's lunch. "We've got Salisbury steak puree with a carrot and pee medley puree. I thought you might like a chocolate malt, too. The doc suggested Bobby and I mix in a chocolate can of Ensure, too. The malt is almost the right thickness but I did add just one tablespoon of your Thick-it. Hey, I got some of that vanilla pudding you like, too."

"Thanks Dean," Sam watched his brother put the food down on his rolling hospital bed table. Sam knew he was getting worse and even now it was becoming even harder for him to get around and he wondered how much longer it would be before he couldn't even bathe himself. As it was Dean had bought a shower chair that fit inside the shower with Sam, so he could sit down and wash himself if he felt unstable or got tired of standing. Sam spooned his puree and his hand was shaking and he dropped some on his shirt. "Dammit," he hissed.

"Hey, it's okay," Dean said hurriedly. He grabbed a clean wash cloth from the side of the bed. "Here," Dean went to wipe it off Sam's shirt.

"Don't," Sam shouted and pushed his brother's hand away from his chest. "I ddd…don't need cleaned up like a damn bbb…baby," he raged. "Just leave me alone," hot tears filled Sam's eyes against his best efforts to hide them from Dean. "Please," came out quiet and broken.

"Yeah, okay Sammy," Dean was quiet. "I … I'll just let you …" he stepped back. "Sorry," he turned and left the room quickly unable to look in his little brother's eyes and see the tears threatening to break free. Dean hurried through the house toward the front door.

"Dean?" Bobby had heard Sam yell and was on his way in to check to see if everything was okay. "Where you goin'?"

"I need some air," Dean said over his shoulder as he opened the front door and went outside. Bobby could hear the emotion in his voice. He walked toward the library and checked in on Sam.

"You okay?" he asked from the doorway.

"Where'd Dean go?" Sam looked stricken.

"Outside, he'll be okay," Bobby assured. "You want to tell me what had you so worked up?"

"I was sss…stupid," Sam said quietly. "I dropped some food on myself and he tried to clean it up and I…"

"Felt crowded and coddled?" Bobby suggested with a soft understanding smile. Sam nodded slightly.

"I shouldn't have said…"

"I'll go talk to him Sam," Bobby replied evenly.

"I didn't mean to…"

"I know and so does he," Bobby looked at the tray of food. "You going to be okay while I'm outside talking to your brother?"

"Yeah, I won't choke to death," Sam's voice held a little bitterness but it wasn't toward Bobby but the situation and the older hunter understood that completely.

"Okay, I'll get him back inside kiddo, no worries," Bobby assured. Sam offered a small lopsided grin in return.

**Outside in the Salvage Yard**

Bobby walked into the car yard in search of Dean he figured the kid wouldn't have gone too far and he was right. Dean was just inside the yard sitting on the hood of and old Pontiac. Bobby sat down on the hood beside Dean. "How you doin' kid?"

Dean looked at Bobby for a second and then let his eyes settle on some distant point out in the yard. "Sammy okay?" he said without looking at Bobby again.

"He's worried about you," Bobby offered. "You know he didn't mean …"

"I know that," Dean looked at Bobby.

"Do you? Cause' he's worried he might have pushed you too far. I mean he didn't come out and say that but he did say he didn't mean to say it," Bobby paused. "Dean, you know as desperate as we both feel about everything that boy in there is feeling it a thousand times worse and he was just feeling crowded and like he wasn't in control anymore…"

"I know, don't you think I don't know that," Dean lamented. "Dammit, I want him better. I want that damn disease out of him. He's just a kid Bobby. Are you sure none of your leads have any suggestions?"

"Dean I have turned up every rock and spoke to every contact I could locate. It ain't no curse that entity put on your brother. It just gave him a disease, an accelerated version of a real disease. How do you fight that? Cure that? The disease may have had a supernatural catalyst but it's the real deal … taken on a life of its own." Dean looked at Bobby with anguished eyes.

"I can't lose him Bobby," Dean choked. "There has to be something. I can't give up on him … I won't."

"I won't either, but we gotta think about Sam too and do what we can for him in the interim, okay?"

"Yeah," Dean agreed quietly. There was a long pause between the men. "He's getting worse Bobby," Dean said quietly.

"I know."

Both men sat silent beside one another for a few minutes neither saying anything more about the reality they were living. "We better get back in to Sammy," Dean broke the silence. "I don't like him eating alone." Bobby nodded and both hunters stood up and walked back to the house.

**10 Days Later, February 27, 2006, Greene Memorial Hospital, Outpatient Center**

Dr. Finley sat at a table with Dean and Bobby providing them an update on Sam's latest appointment. "Dean, I'm sorry that it seems his mobility issues appear to be progressing rapidly since our last visit. His speech is showing more episodes of slurring and/or stuttering." Dean offered a tight nod. He already knew this, after all, he and Bobby were with Sam 24/7 and now Sam couldn't even get out of bed on his own without Dean taking most of Sam's weight and he needed help transferring to the wheel chair. Now, Sam could not even shuffle with the aide of the rolling walker. He could stand but only with support, but needed a wheelchair to get from room to room.

"He can still bathe himself," Dean offered up defiantly in his brother's defense. He felt helpless and needed to say something that could indicate his brother was still here and could do some things on his own.

"Yes, which is excellent considering how advanced the disease is becoming. Is he able to complete all of the tasks still?" Dean sobered at that question and shared a look with Bobby.

"No," he answered quietly. "I shave him when he needs it and I have to wash his hair for him now, but…"

"I know Dean it is a positive highlight that he can still adequately bathe himself. Have there been any incontinence episodes yet? Sam said no when I asked him."

"No," Dean barked and then quickly added, "I'm sorry…"and he dropped his eyes. Bobby felt the need to add his voice into the conversation.

"Doc, we're just still feeling our way through this and looking for ways to help Sam. There haven't been any issues yet."

"Good, but it is likely that it will occur and when it does…"

"We'll handle it," Dean's voice was firm.

"Dean, I don't think you're fully understanding the issue at hand, once your brother starts having problems he'll require adult diapers, and need cared for as you would a baby, really," the doctor offered with somber eyes. "Sam has indicated to me that he does not want to remain home when the disease progresses to this stage."

"I know, okay?" Dean's voice was angry. "He said that back when he was diagnosed and read that damn booklet he was given and it mentioned it. I don't want him going to some care facility; we can get help to come to my uncle's."

"Yes, of course, I could provide you some references of two excellent home care providers that we recommend, however you're more than welcome to find your own, as well. But, Dean, Sam is still able to communicate what he wants, so it will have to be his decision."

"I'll talk to him. I don't want him in a home. He has a home." The doctor nodded. The doctor cleared his voice and Dean knew something else was coming.

"What is it?" he was on edge instantly.

"It's just that during this visit Sam indicated that he wanted more information and paperwork on putting an Advanced Directive on file and has considered a Living Will be drawn up." Dean flinched as if he'd been struck.

"No! Hell no!" he barked.

"Dean," Bobby leaned forward and put a calming hand on the young man's shoulder.

"No," he jerked from the touch.

"Dean," the doctor began. "It's just paperwork that would indicate …"

"I know what the hell it is," Dean hissed. "I read the same friggin' booklet he did. It lets him say he doesn't want certain stuff to keep him alive."

"Essentially yes," the doctor agreed. "Dean, it's a PSP patient's way of assuring that once they are unable to make decisions for themselves that they still have a say and that they still have control. He has indicated that he doesn't want to remain home until he dies that he'll want a hospice placement. He isn't declining care per se, but he doesn't want long-term life support should it come to that in the event he suffers a lung aspiration that he will not recover from with medical intervention. He does not want to be on a vent long-term should a situation warrant it." Dean's throat was tight and he'd taken just about all he could for today.

"I need to see Sammy," Dean spoke quietly and looked at Bobby and then the doctor. "I want to take him home."

"Certainly, he's down the hall in his regular exam room. I'll see you in two weeks, unless you need to bring him in sooner." Dean nodded and stood up and walked stiffly to the door. He needed to talk to his little brother.

**Meanwhile, Outside El Paso, Texas**

John loaded back his equipment into his truck. It was an easy haunt to clean up and he finished the hunt quickly. Now, he wanted to get back to hunting the demon down. He stopped and flipped open his phone and listened to his saved voice mail from Dean. He'd listened to it the first day it had come in almost a month ago, but he had been on a hot lead tracking the demon and dismissed it but his gut had been telling him he shouldn't have ignored it, but he passed that off as his father radar was interfering with the hunt for the demon. He listened to it again:

_Hey Dad, it's me. Um, look there some stuff happening and we need you, okay? Um, we're at Bobby's. Call me or come to Bobby's, okay?_

John frowned at the message. He couldn't deny that Dean sounded emotional although he was doing a pretty good job of hiding it. If it were a real emergency he would have called back, right? He wondered to himself. They're at Bobby's, so things can't be all that bad. He closed his phone and then the memory of Sam calling him a couple years back when Dean had been hurt on that hunt where he damaged his heart and the doctor's said there wasn't anything more to be done. He had let them down then and not called back and the knowledge that Dean could have in fact died if Sam hadn't saved his brother by finding the faith healer hit him. He let out a sigh and climbed into his truck. He pulled out onto a dusty road and headed for the highway. He was headed for Singer's Salvage Yard and to see his boys.

**To Be Continued**


	6. Fading Light

Disclaimer: refer to chapter one

**NOTE TO READERS: **I wasn't sure I'd get a chapter out to you this weekend. There is so much going on but I hope this chapter meets expectations although I'm a little worried I fell a tad short on this one in terms of what a lot of you were wanting. It's about 5 pages long. I probably won't be able to post next weekend as we are having my Mom's memorial service on Saturday and family is coming in from out of town. So, I will try to work on the next chapter and post just as soon as I can. Thanks again to everyone that has reviewed or PM'd me. I appreciate your kind words and support you've been giving me. Thanks again.

Happy Reading, I hope.

**So Long, Good-bye**

**Chapter Six: Fading Light**

By Dawn Nyberg

"_Will you think that you're all alone when no one's there to hold your hand? And all you know seems so far away and everything is temporary rest your head, I'm permanent…"_ Lyric excerpt by David Cook, _Permanent_

**Three Days Later, Singer Salvage Yard**

John pulled down the dusty gravel driveway. It had taken him a day longer to get here than he expected but the flat tire wasn't planned and not having a spare had him stuck in a small town while they ordered the tire from two towns over and had to wait for them to deliver the tire the next day on their regular parts run. He hadn't called his boys or Bobby to alert them to his arrival. He hoped his boys were still at Bobby's but if they weren't he'd touch base with Bobby and find out how his boys were fairing on their own since the wreck.

He saw the Impala as soon as the house came into view. It looked cleaner than he remembered and there was a ramp off to the side of the staircase now. John quirked his eyebrow at that, but shrugged and blew it off. He got out of the truck and walked up the steps. He knocked on the door but no one came to open it up. He looked at his watch, it was a little after 2:00 in the afternoon and he saw that Bobby's truck was here, as well. He tried the doorknob and the door opened with a quiet creak.

**Meanwhile, in the Salvage Yard**

"Almost done Dean," Bobby assured. "Thanks for helping with this order. Hank will take it for me later." Dean nodded and glanced at his watch. "I'm sure he's still sleeping Dean," Bobby smiled. "Anyway, he's got the walkie-talkie and if he needs us he'll use the beep signal button."

"Yeah, you're right," Dean agreed. "I just don't like being out of earshot, you know?"

"I know, but hey at least he's been willing to listen to our suggestions about his care. Has he filled out the paperwork Dr. Finely sent the other day to the house?"

"No," Dean's eyes showed the emotion that was close to breaking free. "This advanced directive crap makes me sick to my stomach Bobby. I hate it."

"I know, me too, but I understand it thought."

"I do too, but I want him here and not in some home."

"It's a hospice Dean and he's not ready for that yet. He's been willing to consider staying here if we aren't the one's doing all of the care. He's got his pride, you know. He needs some dignity and I think the idea of having his big brother bathing him or changing diapers is too much for him to think about and his instinct is to remove himself from the picture."

"He doesn't have anything I haven't seen already Bobby," Dean complained. Bobby shook his head.

"Ain't the same thing and you know it. How would you feel if Sam had to bathe you or something?" Dean nodded sadly. He understood his brother but it didn't make it any easier. "Come on and let's finish getting this boxed and ready for Hank and we can get back in before Sam wakes up."

**Back at the House**

John dropped his duffel bag near the door. He looked around and couldn't dismiss the changes that had occurred. The usually cluttered home was now clean and well kept. There were no more stacks of papers and books gathering dust, instead the place was clean and dust free. He stepped into the room further and noticed a rolling walker off to the side in a nook. He frowned. He stepped into the family room and glanced down the hallway toward the library and saw a wheelchair parked just at the threshold of the double wide wooden arch into the room. The double wood doors were open and soft light was lighting the hallway. John walked toward the wheelchair and when he reached the doorway and looked into the room his heart skipped a beat at what greeted his eyes.

Sam was in a hospital bed covered with a pale yellow woven cotton blanket. His head was rested against two pillows and the electric bed was angled up. Sam was clearly asleep. John just stared at the sight, his hunter's eyes sweeping the room and cataloging contents. He saw sterile wipes, a rolling hospital bedside table, and various other supplies. He felt a tremor work through his body and he stepped further into the room. Sam looked thinner, weak, frail even. John stood next to his child and watched the gentle rise and fall of his chest assuring him that his youngest was alive. He reached his hand up and gently brushed back his son's long, unruly bangs. "Sammy?" his voice was soft and questioning. His youngest stirred under his father's touch. "Son, its dad." John wanted to shout to demand answers but just seeing Sam in this state had triggered something in him that left him stunned.

Sam opened his eyes and blinked at his father. "Dad?" the voice was unsure and the speech slightly off, slurred. John frowned, was his child drugged, sedated. _What the hell is going on?_ His mind growled.

"Yeah, it's me Sammy, hey kiddo?"

"What are you doing here?" The words were slow and deliberate. It was obvious to John that Sam was trying very hard to speak properly. "Dean called didn't he?"

"A month ago, but Sammy he never said anything about this," John's eyes blazed. "Sammy what is all of this?" His voice wasn't soft but flitted between concern and anger.

"Drew the short straw," Sam offered up trying to lighten the situation.

"What the hell does that mean?" John barked, his temper starting to show despite his attempt to curb it. "Samuel I demand to know what is wrong."

"Something's wrong in my head … PSP, I got PSP," Sam offered as he broke eye contact with his father. Yet one more thing Sam was beginning to have trouble with, keeping his eyes focused and maintaining eye contact.

"What the hell is PSP? Where's your brother?"

"Outside with Bobby … be back soon," Sam tried to assure. Sam picked up the walkie-talkie and pushed the red call button.

**In the Yard**

The call button sounded just as Dean was taking a drink of cold water from his bottled water and he looked at the walkie-talkie. "Go, I'll be along in a minute," Bobby said easily.

Dean walked to the house with a quickened step. They had been using the walkie-talkie's for the last couple days and was used to the call button going off. However, when he saw the large truck he knew was his father's he started running for the steps, he took them two and three at a time. "Sammy!" he shouted when he ran into the house. John was already stalking down the hallway.

"Dean what in the hell is going on around here?" Dean resisted going off on his father and tempered his voice before he spoke.

"Hey, Dad, look let me check on Sammy real quick and we'll talk, okay?" John nodded stiffly to his son and allowed Dean to pass by and go check on his little brother. He turned and followed.

**Two Hours Later**

They had all sat and talked and John now sat at the kitchen table staring at the PSP booklet he had read. They had filled him in on the hunt with the entity and that they had turned up every contact and lead they could but hadn't found a way to save Sam from this disease. Sam was asleep once again and the three hunters sat silently in the kitchen.

"Jesus, Dean," John finally found his voice. "You didn't think to tell me this on the phone or at least say Sam was sick and I needed to come, dammit!"

Dean's eyes blazed. "Listen here, we've been over this … you got on my case back in Salvation when I didn't tell you about Sammy's visions, but what the hell difference would it have made, huh? He called you and basically told you I was dying and you never showed up, hell you didn't even call … so it wouldn't have mattered anyway. You don't leave messages like that on voice mail … yeah, um Sammy's basically dying Dad, drop by if you can, yeah, right," Dean leaned back and crossed his arms tightly across his chest.

John wanted to explode, wanted to yell, but instead he let out a long frustrated sigh and conceded as he had in Salvation, "you're right." He looked at Dean and Bobby. "There has to be something to reverse this."

"Johnny," Bobby started. "I've called every contact and lead I had or was told about and they all say the same thing. What this entity did wasn't any curse, it just gave Sam this thing and it isn't supernatural. They say there isn't any known cure or ritual to stop what is happening to Sam.

"We're losing him Dad." John's mind was wild with thoughts. He couldn't fathom losing a child. He had felt the desperation after the wreck when Dean was on life support in a coma and now after listening to everything that Sam couldn't do now, the pureed foods, needing help to the bathroom … it was all so overwhelming. His boy wasn't lost, not yet, there had to be a way. He'd make one if there wasn't. They weren't losing Sam and he wasn't losing his child.

"No, we aren't," John's voice was strong. "There's got to be something we haven't thought of …"

**Meanwhile, back in the Library **

Sam had awakened a few minutes ago and sat listening to bits and pieces of the conversation that filtered down the hall. It was an old house and the walls were thick and sounds were muted sometimes silent all together. He licked his lips and eyed the water bottle that Dean had left behind when they had all sat around Sam and had talked over what the doctor had been saying and had told John about the need to thicken his foods, etc. He grasped the uncapped bottle. He wanted so desperately to feel the cool water run down his throat and not some thick water solution that he had to drink these days because of his swallowing problems. He took a small sip and the coolness felt wonderful. It had been a small tentative sip, barely anything to slide down his throat. He took another sip this time a little more and it went down easily. Just one more he thought and he allowed himself the luxury of a solid drink, filling his mouth with the cool water and allowed it to slide down his throat only it didn't and he felt his air shut off as he coughed violently. He inhaled and felt the water fill places it shouldn't, his inhale was wet and ragged. He coughed again but it was weaker. He felt like he was suffocating and he struggled to sit up more to clear his airway. He coughed but it didn't help, he struggled and panic was setting in.

"Did you hear that?" Dean stood up. "Sounded like Sammy was coughing. I'm gonna go check on him. I'll be back." John and Bobby nodded.

Dean walked through the family room and down the hallway toward the library. "Sammy, are you …" his statement broke off. Sam was leaned back against the pillows slightly off center, his eyes were rolling back into his head and Dean could see the gray pallor of his brother's skin and the pale blue tinge barely perceivable at the corners of his brother's mouth. He saw the water bottle on the floor near the bed and the remainder of its contents ran out on the wood flooring. Dean understood in that single terrifying instant, "Sammy!"

Dean's horrified and panicked voice reached the kitchen and both Bobby and John were running toward the library.

**To Be Continued**


	7. Grasping Straws

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks again for the reviews and PM's of support and encouragement. This chapter is around six pages long. I was pleased to hear that the last chapter was enjoyable, although I was worried about it meeting expectations, just as I am about this one, too. Thanks for sticking with the story, so far and I will try to keep up with the updates. I just never knew how much I'd have to take care of and do, so I'm a bit overwhelmed at the moment, but I will make every effort to keep updating in a timely fashion. I appreciate your patience and support.

Happy Reading, I hope!

**SIDE NOTE:** I thought I'd pass along to everyone just in case you're interested in reading some SN essays from the March released book from Ben Bella Books "In the Hunt" … I have added the link to my profile page. There was an essay contest sponsored from the publisher early in 2008. They have published the winners, but the chosen finalist didn't get in the book except for their names, however their essays including mine can be found at the site link on my FFnet profile page. They also have some excerpts from the winners in the book available to read. Keep in mind this contest was during early season 3 and season 4 hadn't even happened, so some material and/or theories that some writers may have discussed may or may not have panned out.

**So Long, Good-bye**

**Chapter Seven: Grasping Straws**

By Dawn Nyberg

"_Is this the moment where I look you in the eye? Forgive my broken promise that you'll never see me cry …"_ Lyric excerpt by David Cook, _Permanent_

**Two Days Later, Greene Memorial Hospital, ICU**

"How much longer do you plan to keep my son sedated?" John stood defensively near his youngest son's room.

"Mr. Collins," Dr. Finley began. "Sam aspirated fluid into his lungs and in suctioning them we discovered he had vomited, as well when he choked on the water. He was in respiratory arrest when the paramedics arrived, although Dean did an excellent job of rescue breathing for him until help arrived and he is still requiring mechanical ventilation to help his lungs as they recover. I feel sedation is allowing the medicine and the vent to help his body, so we can get him home. It won't do him any good to wake up and fight the vent." John nodded.

"I read the brochures and booklets and they all said that aspiration pneumonia is the most common …" John couldn't finish the sentence but the physician did for him.

"It is true Mr. Collins that aspiration is the most common cause of death for PSP patients, but Sam's aspiration episode was addressed aggressively and I really do feel he'll be headed home in a few days." John looked back into his son's room and watched Dean sitting at Sam's bedside holding his hand and gently stroking a thumb across his little brother's knuckles of his left hand.

"I should go see my boys," John said absently as he looked back at the doctor.

"Of course, should you have any questions, please don't hesitate to ask." John nodded and turned and walked back into his youngest son's room. John had had many questions and over the past two days of staying camped out at ICU or in the unit waiting room he had asked the doctor as many questions about PSP as he could. He stood silently watching his oldest son sit vigil at his little brother's side. John shook the memories of seeing Sam blue and unresponsive when he had run into the library with Bobby after hearing Dean yell his brother's name. Dr. Finley was hopeful and John took some comfort in that but he had read the literature and the physician had explained that Sam's case was not only rare for his age but extremely aggressive in nature. John knew from Bobby and Dean that the reason behind Sam's sickness had been a run-in with a negative entity but they hadn't turned up any means in which to help Sam. John would make some calls but not until his youngest was off the ventilator. John took in a calming breath and walked into the room.

He stepped behind Dean and placed a comforting hand on his oldest son's shoulder and squeezed reassuringly. "He's gonna pull through this Dean," John assured. Dean looked up at his father and offered a tentative smile. It wasn't much but John took some comfort in it and allowed a soft smile to cross his face, too. He gave one last squeeze and took up his seat next to Dean at his youngest child's bedside..

A short while later Dean shifted his eyes from his brother and looked at his dad, "So, you talk to Bobby?" The old family friend had been coming and going allowing John time with his boys.

"Earlier," John answered easily. "He called to see what the doctor said about Sam." John sighed. "I wish I had known Dean."

"Dad, I don't want to have this conversation again …"

"No, I didn't mean … it's just … I'm sorry I wasn't here for you, I know how hard this has to be on you, let alone Sammy."

"Dad, he's been pretty strong through this," Dean looked proudly at his brother. "I mean don't get me wrong he's had his moments … who the hell wouldn't …"

"Dr. Finley mentioned to me about his requests …" John inclined his head toward his youngest son's prone form. Dean's eyes drifted and he shook his head slightly.

"I'm still working on that," Dean answered quietly. "Look, it won't come to that; you know something we can do to fix this, right? Some contact?"

"I'll start making calls as soon as Sam is off the vent, okay?"

"So, you do have an idea?" Dean's voice was hopeful.

"I have some contacts that Bobby hasn't spoken to yet, so I'll try. I won't give up Dean."

"I know," Dean looked back at his brother. "So, are you leaving to go look?" his question was quiet and asked without him looking at his father. John watched his son and smiled to himself.

"I can make calls Dean … I think you boys need me here and I can't leave Sammy not now … I'll …"

"Dad, I ain't gonna lie, I want you here with us but if there is a solid lead that makes you have to leave then…"

"I know," John nodded to his son with a silent understanding. He reached up and stroked Sam's forearm and then allowed his hand to rest there.

**Three Days Later, ICU**

"I want to go home," the words were slightly slurred but understandable. Sam looked at Dr. Finley as he finished listening to Sam's lungs. Dean and John were waiting anxiously along with Bobby in the ICU waiting room while Sam was examined. He had come off the vent a day and half ago and they were eager for some good news regarding Sam's return to home.

"Well, your x-rays look pretty good that were taken this morning. I think I'll move you to the observation unit for today and release you tomorrow … how does that sound?"

Sam smiled and nodded. "Can my family come back in?" Sam's speech was clear that time but only because he had tried very hard to make himself clear and Dr. Finley knew how hard his patient had tried to not slur his speech.

"Sure, I'll give them the good news." The doctor went to leave and stopped. "Sam, what happened to put you in here … the drinking the water, I know how tempting it is but you can't do it again, okay? You must use the thickening agent, so you can help to reduce the risk of another choking incident, okay?" Sam dropped his eyes and nodded.

"Yeah, I know," he answered solemnly. "I just wanted …"

"I know, to drink some normal water and not sludge water," he offered lightly, "but you could have died had your brother not heard you struggling."

Sam looked at the doctor and only nodded once more and the physician offered a supportive smile and left to get his patient's family.

**Two Weeks Later, Late March 2006**

Dean had helped Sam into his wheelchair and taken him to the kitchen dining table, so that he could eat with all of them. They had been eating with Sam in his room but they wanted to give him as much normalcy as possible. Sam had begun having problems with feeding himself in the last few days and would dribble. He had been embarrassed but Dean wouldn't let him withdraw from them. Dean smiled and grabbed a large plastic bib and tied it around Sam in order to protect his t-shirt he was wearing … Sam hated it but he hated having a mess on his clothing more. Sam had also begun having difficulties in dressing himself and had in the last day or two required help in dressing.

The conversation was lively at the table but Sam needed to talk to them. "Here Sammy try another spoonful of sweet potato," Dean had prepared the puree just to Sam's liking. Sam turned his face away and raised a hand in frustration.

"I can … do it," Sam slurred out with difficulty. John watched his children with agony. In the two weeks since Sam had been released from the hospital he had been calling lead after lead and still no one had any solution to helping his child. Dean pulled back the spoon and cast a worried glance at his father. John took the cue.

"Sammy," John started being careful to keep his voice even, "you gotta eat kiddo, but if you want to do it then…" John nodded to Dean and his oldest son put down the spoon on the plate, "go ahead," he urged gently. Sam looked at the spoon and frowned and finally shook his head.

"Need … to talk …" he slurred out.

"You okay?" Dean asked instantly with concern.

"It's … time to …" Sam frowned at his heavily slurred words. He focused to get the next sentence out as clearly as possible. "My appointment with … Dr. Finley tomorrow … the papers … I want the papers."

"No, Sam it's not time for that," Dean stood up and shoved his seat back. "Dad's following up contacts every day we're going to find a way to save you, make you better. So, you're having some more trouble, you don't need some hospice or whatever. You need to be here…"

"No," Sam slurred. "You dress me, feed me now 'cause I can't do it right … soon I won't be able to wash myself and…"

"Stop dammit" Dean shouted loudly and even John and Bobby flinched at the guttural yell.

"Dean, son…" John started.

"What?" Dean turned blazing eyes toward his father. "It's not time, it's not … we still got leads, right?"

"Yes, I still have a few to get a hold of," John assured. "Sammy, son, I have no idea hoe hard this is on you but I know I wouldn't be handling things well if I were in your shoes, so I think I can understand on the smallest level, but your brother is right a hospice isn't for you now, it won't ever be," John affirmed. "Please, stay here, look if having us are for you doing certain things is too difficult for you to allow let me talk to your doctor and see if there is some kind of home visitations that can happen or something a nurse or aide or something … how about that? Would you consider it?"

"Still want the papers made out … I don't want to be on machines, no more vents," Sam slurred out but they all had heard.

"Sammy," Dean jumped in now. "You needed the vent a couple weeks ago, you can't say no when it can help."

"Not saying no to help," Sam assured. "But, I don't want it to be the way I have to live." Sam turned imploring eyes toward Bobby hoping the older hunter understood what he was trying to say.

"I think I know what he's trying to say," Bobby interjected as he smiled knowingly at Sam. "He's just saying if it came down to him being kept alive by a vent or other machines because he wasn't going to be able to sustain himself then he wants to be …" Bobby quieted for a moment and swallowed the thick lump in his throat before he spoke the final words. He took a breath and started again, "if he can't sustain himself he wants to be let go." Sam's eyes filled with unshed tears and smiled at Bobby, a silent thank you in his face. Dean turned away and walked to a window that overlooked the yard. He felt the hot sting in his eyes and knew he couldn't find his voice yet, his emotions still too close to the surface.

"I'll stay … maybe get an aide later we'll see, okay?" Sam offered up an olive branch. "But I get the papers," he asserted firmly albeit slurred.

Dean cleared his throat and turned to look at Sam and then his father. He still didn't speak but he offered a quick, tense nod an agreement had been met.

**The Next Day, Outpatient Center**

Dr. Finley sat at a table with Sam and his family. There were two other medical professionals there to act as witnesses. Sam attempted to scribble his name on the paper. He had made his wishes known … the form was mostly checking off what you want and don't want. Sam had noticed how stiff Dean had sat during the paperwork. It was hard to ignore the impact of a paper that bore the bold printing: _South Dakota Statutory Living Will Declaration_. Sam had needed to fill out a Healthcare Power of Attorney form, as well, and had started to ask Bobby to take on the responsibility should he not be able to communicate at all for himself, but Dean had spoken up and indicated he could do it and would abide by what his brother would want should he not be able to make decisions. Sam had wanted to spare his brother or father that burden but he couldn't deny Dean either.

The day hadn't been a good one and the doctor had announced that Sam had had further progression and that it seemed imminent that there would be more issues to combat sooner rather than later. He had provided some brochures on home care and left the offer open to arrange for the care when they all felt it was needed.

**One Month Later, Late April 2006**

John stayed near his boys and followed up every contact and a couple potential leads that hadn't panned out, but John was quickly coming to the end of his rope on finding a way to save his son, his youngest child. In the past handful of weeks Sam had become more quiet and withdrawn. He would speak but his speech was so difficult to understand most of the time that he was left unable to communicate the way he wanted and desired too. John walked into the kitchen and saw Dean pouring himself a cup of coffee. "Hey," he offered gently. "Sammy still sleeping?"

"Yeah." John wanted so much to help his first born but words were there to help soothe this situation, this nightmare, there were none, so he just made himself available as much as he could. He knew he had been hard on both his boys in their youth but now was not the time for him to be their drill sergeant but they needed their dad and _this_ he could give them.

**Ten Minutes Later**

Sam awoke to a discomfort and moved slightly and then it dawned on him with a horrible realization. He pulled down the sheet and stared, he felt the hot tears well quickly and cascade down his cheeks. Dean and John walked into the library at that moment and saw Sam's anguish and tears. "Sammy?" Dean hurried forward with John close behind, "What's wrong? Are you ..." the words died on his lips when he realized with agonizing understanding that Sam had wet his bed.

**To Be Continued**


	8. Through a Glass, Darkly

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks for all of the review, comments and PM's. I wanted to try and give you all a little longer chapter. You've all been great both in patience and support since the story started and I appreciate it. This chapter is around 10 pages long and I hope it meets expectations. Happy Reading, I hope!

**So Long, Good-bye**

**Chapter Eight: Through a Glass, Darkly**

By Dawn Nyberg

"…_close your eyes and you will see who you used to be left without a warning, who knew one so big could grow so small lighter than the writing on the wall … here we live with bottles and needles and truth here is your living proof that death cannot be proud…"_ Lyric excerpt by Janis Ian, _When Angels Cry_

"Sammy," Dean stepped closer. "It's okay," he soothed, but Sam jerked the sheet back up covering himself.

"Sam, son, it's …" John's voice was tentative.

"Nnn…ooo," Sam's garbled speech was angry.

Dean would later realize that he would block the next thirty minutes out of his mind … the moment of fighting with Sam and holding his arms down as the young man fought being helped as he and his father tried to get Sam up and out of the wet bedding and get him cleaned up. He would block undressing Sam in the bathroom and lifting and sitting him in the tub as his father pulled the wet bedding, sheets and blankets up replacing them with fresh ones and a bed pad on top of the sheets and would put the others in the laundry. Dean had already had a small pack of 10 bed beds shoved in the hall closet that Sam didn't know about but John was both thankful and anguished over this simple pre-planning from his first born. Dean would block his little brother's quiet sobs and whimpers as he gently cleaned his brother up and redressed him in fresh underwear and clean sweat pants and a t-shirt all the while saying soothing words to Sam to try and calm him. Then it was over …

"Need my help getting him back into the room?" John offered quietly from the cracked bathroom door. Dean had managed to pull his brother up.

"No, I got him," Dean's voice slightly strained as he opted to carry his little brother rather than put him in the wheelchair. Sam was still heavy but it was obvious to Dean he had lost some muscle mass and some weight, too. "I got ya Sammy, you're okay," he soothed once again. Sam was quiet now and wouldn't look at his brother or father not that he really could anyway. Sam over the last month or so could barely hold eye contact without his eyes wandering off despite his best efforts to keep looking at someone or something, yet another loss due to PSP.

**Three Hours Later**

"Guys," Bobby broke the silence around the kitchen table. Sam had fallen into an exhausted sleep back in his makeshift room in the library.

"I know, okay," Dean spat quietly. "I'll call Finley and ask him to make some arrangements."

"Dean, son we're not giving up, alright? I haven't stopped calling contacts and following possible leads but we have to keep Sammy comfortable and what happened today…"

"Look I know, okay? You think just 'cause it wasn't me on the receiving end of that experience that I don't know how much it hurt him, embarrassed him, but he shouldn't feel…"

"I know we don't think he should Dean but he's an adult and he feels he's lost what bit of control he had and dignity." John offered quietly. He couldn't believe those words were coming out of his mouth especially in relation to his baby son, but they were. "We liked the care brochure for that company, _Comfort Keepers_ do you want…"

"I don't want," Dean answered abruptly but he sighed and remembered Sam's explicit wishes and that Dean had agreed to follow Sam's wishes and with Sam's Healthcare Power of Attorney entrusted to him by his little brother he wouldn't let him down. "I know what he wants, it's just…"

"I know son, I know," John tried to comfort. "Do you want me to call the doctor and you sit with Sammy?"

"No, I got it," Dean pushed himself stiffly up from the table and walked into the family room to make the call.

**One Hour Later**

Dean sat by Sam's bedside. "Hey kiddo," he offered lightly at his brother who was looking out the window as best he could. "I talked to Dr. Finley, okay? Sammy, it's not time to take you anywhere … remember you agreed to try healthcare aides and nurses?" Sam turned his head toward his brother. His eyes met his brother's for one glorious moment and drifted off again not keeping solid contact. He nodded.

"Rrr …remember," he forced out.

"Sammy, they're gonna call in a little bit the doc said and make arrangements to start coming. He said they'll probably be asking what you prefer … you know … a guy or girl takin' care of ya when they're here," Dean took a breath and concentrated on not letting his voice waiver, he had to be strong for Sam. "The doc said this company makes an effort to be consistent with a couple caregivers to any one patient, so some days you may have one and then others the next, but always the same two unless something unexpected happens, that'll be good, right?" he offered trying to sound upbeat. Sam just nodded but Dean saw his brother's hands clenching and unclenching the cotton blanket that covered his legs. He put his hand up and grasped his brother's right calf and gently squeezed. "Easy, Sammy," he soothed. "You're not alone kiddo you never will be," he said in gentle firmness. He wished Sam could still talk like he did but it was so difficult for him now that what little words he did force himself to utter were like little miracles to Dean and he clung to them even when they were garbled and slurred.

"Ddd…don't care ggg…girl or ggg…guy," Sam forced out. "Hhh..heavy," Sam started and looked frustrated when he knew what he wanted to say would take a while to get out.

"Heavy?" Dean looked a little confused and then he smiled softly as he understood. "You're not a heavy weight Sammy and anyway the doc gives them all of your info, so they won't send someone who can't handle things and we're here to help, too. Look, I get that you want help with some stuff from somebody other than Dad, me or Bobby, but I still gotta be able to do something. I can help moving you and stuff," there was a hint of pleading and hopefulness to Dean's voice that Sam picked up on easily. His body was failing him but he still knew his big brother better than anyone else in the world, even their dad.

"Okay," Sam slurred out and Dean offered a gentle smile in return and patted his brother's leg. The phone could be heard ringing in the family room and shortly after there were footsteps down the hallway on the wood floor.

"It's the healthcare place," John said from the doorway. "I'll keep Sam company while you talk to them, okay?"

"Be back soon Sammy," Dean smiled and left the room.

**One Week Later, May 1, 2006**

"I wish I had better news I do," Dr. Finley offered. The doctor knew that tomorrow was Sam's twenty-third birthday and what he had just conveyed to Sam's family was difficult.

"You're sure?" John winced at the shakiness of his voice.

"Yes, unfortunately," the doctor began. "It's clear that Sam has fully moved into stage three of the disease process and has begun exhibiting some random symptoms associated with stage four, as well."

"He hurts," Dean's voice was quiet. "The nurse suggested Tylenol and heat rubs but it doesn't really help, not like it did. I don't want him in pain."

"I know it's difficult but PSP patients frequently experience non-specific pain in the late stages."

"I know," Dean's voice was flat. "I've read more journal articles and other crap about this damn thing than probably you," he spat. "I want you to give him something for the pain. There has to be something that can help." The doctor didn't take offense to Dean's anger because he knew when it came to his younger sibling Dean was a pit bull.

"I'm sure you probably have read more than me," he offered. "It appears based on your observations and mine that his limbs seem the most painful to him, yes?"

"Yeah, please I just don't want him in pain."

"I'll prescribe something for him that your R.N. caregiver can administer to him when he has a pain episode and we'll see how that goes. I may consider prescribing him a pain patch, as well. I know you want him comfortable, me too, but with non-specific pain sometimes finding the right med can be trial and error, so let's see how this one goes."

"Thank you," John offered genuinely. Bobby offered a nod of approval.

"I also wanted to address his recent exam and tests and I feel it's time that we consider a feeding tube."

"He can still eat," Dean said quickly.

"His choking is becoming worse Dean even with the use of the thickening agent. It's becoming too dangerous to allow him to keep eating. Also, it's clear he is no longer wanting food as much and he has lost weight …"

"I know," Dean conceded. "I make sure what he eats when he eats is healthy … I even add those concentrated vitamin and mineral drops to his milk shakes, I…"

"Dean you and your family have done an excellent job with Sam, but we are at that fork in the road. I know from Sam's directive he indicated that he would allow hydration by IV or the NG tube. He also agreed to allow a NG tube to be placed but he was very definitive on the fact he did not want a surgically placed feeding tube in his abdomen. Although, it was discussed at length with him that a surgical tube is the preferred method for long-term placement but he was very clear on his denial of surgical placement. You have his power of attorney, so I need your approval."

"The NG tube," Dean began with a hesitant voice and John placed a calming hand on his son's shoulder. "It's the one that goes down his nose into his stomach, right?"

"Yes, and can be easily removed if needed."

"You're sure he needs it now," Dean didn't want to accept that it had come to feeding tubes and IV's. Sam was still his little brother and he might not be able to communicate that much anymore but he still smiled and Dean knew he was in there but his body was just betraying him.

"Yes, it is my professional opinion that it is needed and I conferred with Dr. Litvan and she agreed that based on the progression and increased swallowing problems even with the thickening agent that it would be in Sam's best interest to have the tube placed. I'm not saying that the occasional nutrition by mouth is out of the question but he'll beginning receiving most of his sustenance by the tube. His caregiver will provide additional oral care for him since he won't really be consuming much pf anything by mouth now. Of course, he could refuse the tube at some point which some patients will do, but we'll cross that bridge if we come to it. "

"Does he know about you wanting to put the tube in?"

"Yes, I spoke with him after his exams. I know he understands me but as you're well aware his communications abilities have severely declined since our last visit." Dean nodded.

"Fine, give me the paper; I'll sign for the tube." Dean signed and pushed the paper back toward the doctor.

"I'd like to do it today," Dr. Finley began. "I know tomorrow is his birthday, so if you want to make him a thickened ice cream malt or something it should be okay just monitor him. Sometimes there is a bout of depression for PSP patients once a tube is placed. It's once less control they feel they have," the doctor paused a moment and looked at Sam's family. "The trips are getting harder for him to come here even with the _Comfort Care_ nurse helping, so rather than change his care over to a visiting physician program I'd like to remain Sam's doctor and just come to see him at your uncle's."

"You can do that?" Dean asked suddenly. It was pretty stressful for all involved when Sam had his appointments especially for Sam.

"For most of the check-ups yes, but when there are more extensive exams I'd rather him come to the Outpatient clinic. I can send someone out for blood work or other simple lab testing and have the results prior to my visit. There are of course some lab work he may need that will require a trip in but I will make every effort to reduce those visits, if possible, but they be necessary as long as he remains at home and not an outside facility."

"We understand," John broke in. "We're thankful you're willing to remain Sam's doctor I'm not sure he'd take to the change with a new physician very well."

"Yes, I agree and I'm happy to do it. Now, about the placement of the tube … I'd like to be today. Sam's personal nurse is with him in the exam room, but would you …" he looked at Dean.

"Yeah, I want to be there for him. Will it hurt?"

"It won't be comfortable but pain shouldn't be a real factor. I can spray a small amount of numbing agent to the back of his throat to help a little, okay?"

"Thanks." Dean looked over at his father and then Bobby.

"We'll be here son, go be with Sammy."

**Ten Minutes Later, Treatment Room 2A**

"Okay, Sam here we go? It'll be done soon," Dr. Finley encouraged. Sam squeezed Dean's hand in fear.

"It'll be okay Sammy, I'm here," he soothed. Sam's eyes went wide as the NG tube entered his nose and followed the doctor's instruction's for swallowing; he gagged at the intrusion he felt going up his nasal passage and down his throat into his stomach despite the spray. "Easy, Sammy," Dean felt his stomach clench and the bile rise at what his little brother was going through. The doctor handed the nurse a cup.

"Here Sam, drink this thickened liquid and swallow this should help with the gagging, okay?" Sam nodded and did as he was told. "There," Dr. Finley said confidently. "It's done Sam. It's over, no more, okay?" He patted Sam's leg. The doctor finished checking placement and one final exam and talked to the family about the tube and talked to the nurse and Dean and sent his patient home.

**Two Days Later, Bobby's House**

"You've got it down Dean and your father and uncle did great with the tube feeding, too," Valerie, Sam's home care nurse encouraged. She had shown all three men how to use the NG tube and introduce nutrition into it for Sam.

Sam plucked at the tape holding the small port end of the tube to his cheek. "Here sweetie, I'll get the cotton tape and that should stop the itching from this tape.

"Thhh…Thank you," Sam slurred out. Dean smiled at his brother. His sibling was quiet the last couple days and he feared depression had set in as the doctor had warned but Sam seemed to be rallying a little but Dean suspected it was more for him and their Dad, Bobby, too. He was thankful that Sam was still able to enjoy his birthday ice cream malt by mouth the other day without problem but had had a small choking incident when he tried to eat something else later without using the tube but Valerie had been able to suction him and had encouraged the use the NG tube.

"There, how's that?" Valerie asked in her usual cheerful voice as she smoothed the new cotton tape onto Sam's face. She had been very helpful to not only Sam but everyone in the house. She had had two other PSP patients in her career as a nurse, one as recent as a year ago and she was a welcome resource for Dean when he had questions on how to help Sam as much as he could.

"Thanks, Valerie," Dean answered easily and Sam offered a small smile toward the middle-aged one, of what Dean figured was around forty-five.

**Two Weeks Later, Mid-May**

Valerie was down the hall getting some clean wash cloths for Sam's room while Dean administered Sam's afternoon feeding. John and Bobby had gone to town for a grocery trip and John was meeting with a fellow hunter to discuss a possible lead for Sam. They didn't do any hunting or supernatural business around Valerie and kept those books and items out of her view.

"Okay, Sammy, looks like we've got some Ensure and the special diet cocktail the doc prescribed for ya to put some meat back on those bones." Dean smiled at his brother. Sam would smile back but his communication had become worse over the last week and now would only speak every so often. Dean hated a silent Sam but the alternative was unthinkable. Dean wanted to hope for good news when his Dad returned from his meeting in town but hope was a rare commodity these days and he wouldn't waste one minute with his little brother. "Okay, one last bit and…" Sam jackknifed up and began vomiting the mixture, he inhaled and gagged wetly. He began grabbing at his throat in desperation. "Sammy! Help! Valerie!" It had always been a potential risk that the tube could promote vomiting but there hadn't been any problems since its placement a little over two weeks ago.

Sam was already losing consciousness when Valerie ran into the room. "Dean!" her voice was urgent as she went to Sam. "Call 911, tell them Sam has aspirated vomit and isn't conscious," she hurriedly placed a stethoscope to her patient's chest. "He's not moving any air. Tell them he's not breathing but a nurse is present, go!" Valerie quickly grabbed a suction tube to help clear some of the vomit and went about helping Sam to get some much needed oxygen.

**Twenty-Four Hours Later, ICU**

Dean ran a hand over his tired eyes. "The aspiration event is much more severe this time Dean, and he has a bad case of aspiration pneumonia," Dr. Finley spoke with a solemn voice.

"But, you're treating him, he'll be okay, he just needs some help right now." Dean's voice was ragged.

"Dr. Finley, my son, can get through this can't he?" John stood stoically next to his eldest son with Bobby close by. His lead from the previous day hadn't panned out and he was still no closer to saving his son.

"Sam has developed a significant fever and we are addressing it aggressively, but his body is weakened and…"

"No, you keep treating him and he'll get better, he will," Dean prompted as he looked through the glass window at his brother.

"Dean, he isn't currently triggering the vent at all and his lung volume is poor despite the best efforts from the Respiratory Department. They are addressing his secretions and trying to suction his lungs more deeply, but…"

"No, he can come back from this," Dean assured. He was quiet for a moment. "Doc?"

"Yes?"

"Valerie said, I didn't do anything wrong with the feeding, but could I…"

"No, Dean, this was always a potential complication from the NG tube that's one of the reasons surgical tubes are preferred for long-term feedings but Sam was quite sure of what he wanted. This isn't your fault." The physician assured.

**Two Days Later, ICU**

Sam's fever was still present and they had begun more IV antibiotic treatments. The Respiratory staff came and went suctioning, checking and adjusting settings on the vent and taking arterial blood gas reading from the PICC line that the doctor had placed the other night. Dean's mind remembered the patient brochure the doctor had provided him before he signed the consent, although it was designed to be read by the patient, it was his decision to make for his brother who wasn't conscious.

The info as always seemed overwhelming to him as he had read it:

**What is a PICC Line and Why Do I Need It?**

A PICC line is, by definition and per its acronym, a peripherally inserted central catheter. It is long, slender, small, flexible tube that is inserted into a peripheral vein, typically in the upper arm, and advanced until the catheter tip terminates in a large vein in the chest near the heart to obtain intravenous access. It is similar to other central lines as it terminates into a large vessel near the heart. However, unlike other central lines, its point of entry is from the periphery of the body and the extremities. And typically the upper arm is the area of choice.

A PICC line provides the best of both worlds concerning venous access. Similar to a standard IV, it is inserted in the arm, and usually in the upper arm under the benefits of ultrasound visualization. Also, PICCs differ from peripheral IV access but similar to central lines in that a PICCs termination point is centrally located in the body allowing for treatment that could not be obtained from standard periphery IV access. In addition, PICC insertions are less invasive, have decreased complication risk associated with them, and remain for a much longer duration than other central or periphery access devices.

Using ultrasound technology to visualize a deep, large vessel in the upper arm, the PICC catheter is inserted by a specially trained and certified PICC nurse specialist. Post insertion at the bedside, a chest x-ray is obtained to confirm ideal placement. The entire procedure is done in the patient's room decreasing discomfort, transportation, and loss of nursing care.

A PICC line may requested for a variety of treatment options which include some of the following:

-Prolonged IV antibiotic treatment;

-IV access obtainable by less invasive and longer lasting methods;

-Multiple accesses obtainable with one access line;

-TPN Nutrition;

-Chemotherapy

-IV access related to physiological factors; and

-Home or sub-acute discharge for extended treatment.

PICCs are frequently used to obtain central venous access for patients in acute care, home care and skilled nursing care. Since complication risks are less with PICC lines, it is preferred over other forms of central venous catheters. A PICC is not appropriate for all patients. Proper selection to determine the appropriateness of this device is required.

The PICC may have single or multiple lumens. This depends on how many intravenous therapies are needed. A PICC line can be used for antibiotics, pain medicine, chemotherapy, nutrition, or for the drawing of blood samples. PICCs can be inserted by radiologists, physician assistants or certified registered nurses. They are inserted using ultrasound technology at the bedside or ultrasound wit fluoroscopy. Chest radiographs are also used to confirm placement of the PICC tip if it was not inserted using fluoroscopy.

Dean and his father sat at Sam's bedside both feeling lost from the doctor's last visit a short while ago. Sam's condition hadn't improved and in some ways had worsened. They were now adding an IV drug to help with Sam's low blood pressure and Dr. Finely had said with solemnity that Sam's condition was very critical and if he didn't start responding to the treatment soon that his Advanced Directive may have to be considered being implemented. Dean shook his head, that wasn't happening, it was too soon. Sam was still alive, his heart still beating and in Dean's book that meant somewhere in there his brother was fighting and he'd make damn sure he got all the help he needed to win this battle. Sam was coming home and there wasn't another possibility. Dean wasn't letting him go…

**To Be Continued **


	9. Stop All the Clocks

Disclaimer: refer to chapter one

**NOTE TO READERS: **Okay, I wanted to get this chapter out since my schedule will start getting even busier than usual. Plus, I'm getting over walking pneumonia, and then as an added bonus I came down with an acute sinus infection topped off with an ear infection this week, too. Fun times, not. This chapter is around 8 pages long and I tried to give you all a little break from a cliffhanger, so I hope this chapter satisfies and doesn't disappoint. Happy Reading, I hope!

**So Long, Good-bye**

**Chapter Nine: Stop All the Clocks**

By Dawn Nyberg

"…_The stars are not wanted now: put out every one; pack up the moon and dismantle the sun; pour away the ocean and sweep up the wood. For nothing now can ever come to any good …"_ Poem excerpt by W.H. Auden, _Stop All the Clocks_

**Four Days Later, ICU**

Dean and his father sat in the ICU waiting room while Sam was examined. They had urged Bobby to go back to the salvage yard to take care of his auto salvage business. The older hunter had assured he'd return later. "Dad, I'm telling you I saw the 'Assist' light on Sammy's vent come on a few times and go back out over the last day and half. I'm not imagining it."

"Let's just wait until Dr. Finley finishes with Sam's exam, okay?"

"Why can't you believe that Sam's gonna pull through this?" Dean's eyes were tired and angry. "His fever is way down and …"

"Dean, son, I agree his fever is down and maybe you did see the 'assist' light come on. It's just I think they'd had said something about it if it had, I mean that machine keeps records, right? Look, I want Sammy leaving this hospital as much as you Dean, but…"

"But nothing Dad, he's gonna pull through this, I know it."

"Dr. Finley's been in there with him over an hour now Dean, it might not be the news you're wanting," John couldn't allow himself to hope too much, he wanted to but after the scare a couple days ago when Sam's heart had gone into an arrhythmia that required emergency treatment, it had scared him and he thought he'd lost his son in that moment but he'd been pulled back from the edge and responded to the drugs he was administered. His heart started beating regularly again and the alarms had quieted, but John's fears still screamed and seemed to block his hope.

"Men?" Dr. Finley's voice stopped Dean from responding to his father.

"How's Sam?" Dean stood quickly and strode toward the doctor. John followed with expectant eyes.

"Here," the physician motioned to the bank of chairs; the waiting room was currently empty. "Have a seat."

"Doctor, how is my son?" John asked standing his ground.

"I guess we're standing then," he offered with a soft smile. "Okay, I'm going to say one thing is certain, Sam is one hell of a fighter." Dean broke into a huge smile and glanced at his father.

"What are you saying?" John pushed. "He's going to pull through this?"

"I had to examine him thoroughly, but I can confirm that he is in fact triggering the vent and now quite frequently. We're going to try and start weaning him slowly over today and if there are no setbacks he'll be taken off the vent completely tomorrow at some point…" John put a hand up and interrupted the doctor.

"But, just a couple days ago his heart went into some kind of arrhythmia and you were saying…"

"I know but he's rallied and the arrhythmia was brought on by his low blood pressure and a sudden decline."

"What about my son's pressure? He hasn't been able to sustain his pressure and…"

"John, over the last couple days the dosage of his IV meds hasn't needed adjusting for his blood pressure and that was a good sign but I just wanted to hold off saying anything because, well, frankly, the kid surprised me and I didn't want to give false hope. But, I've withheld the IV meds for the last hour and he has maintained his pressure. In fact, his BP is pretty good considering where we were a few days ago."

"Sammy's gonna make it out of here isn't he?" Dean rushed his words; his face alight with hope and John reached over and clasped his shoulder, no longer able to deny the possibility that his son would survive this latest setback.

"Well, all signs are pointing toward that and with his pressure maintaining and with more stable vitals, he should be regaining consciousness soon. It might be another day or two but I think Sam fought his way past this bought of aspiration pneumonia."

"I want to see Sam," Dean stepped toward the door and John followed.

"Of course, I'll check back later. I've left word with his day nurse to page me if there are any changes, okay?" Both men nodded.

**Two Weeks Later, Bobby's House**

"The physical therapy is very good for him," Valerie encouraged as she talked to Dean and John while the visiting therapist worked with Sam in his room. "It's good for him to get his muscles worked since he is mostly bedridden unless he's in a wheelchair." Sam had started getting physical therapy visits, although he wasn't able to stand on his own the therapist was still able to stretch Sam out and work his muscles from the bed.

"The pain medication is helping," Dean said as he glanced down the hallway.

"Yes, I think Dr. Finley finally found the right combination for Sam. Margaret tells me he is resting well for the most part at night." Margaret was Sam's evening caregiver who nightly writes up care notes for Valerie to read when she arrives in the morning. Margaret stays with Sam from early evening and through the night, so that everyone in the house can get some sleep. She leaves at 5 AM and Valerie comes at 8 AM to 5 PM but some days she stays later if Sam is having a bad day with allowing his family to care for some things like his evening bath, but sometimes he allows his brother to do it, but Sam can be stubborn. She liked the family and despite the professionalism that is required for her job, she's human, too. She cared for Sam and staying a little later never bothered her. She was a sucker for those soulful eyes of Sam's.

**Later that Day**

"Hiya Sammy," Dean came into the room with a smile on his face.

"Hi," the voice was slurred but it was Sam's and that was a gift to Dean.

"So, I was thinking I'd get you in your chair and take you out on the porch for some fresh air, how's that sound?"

"Ddd…Dad?"

"He's in town kiddo," Dean figured on another meeting for a potential cure but he had stopped telling him. Dean figured it was to prevent him from being let down yet again when nothing panned out. "He'll be back later. Val's on the phone and taking a break. You're stuck with me."

"Not … stuck," Sam forced out and smiled at his brother.

"Well? What about that trip outside, hmm?" Sam nodded and offered his brother a lopsided grin. Dean felt so lucky to have his brother alive and back home. It had come so close the last time, but he pushed those thoughts away and decided to cherish this moment.

**Twenty Minutes Later**

"Nnn…nice," Sam slurred. Dean looked over at his brother and wrapped his arm around his little brother's shoulders and smiled warmly.

"Yeah, it is," he replied trying to swallow the lump in his throat. "You warm enough?" he questioned.

"Sss…Seventy degrees," Sam struggled but got the words out. "I'm okay," he focused and got the words out.

"Yeah, but …" Dean started. Sam shook his head and smiled, so Dean let it go. Sam let a small cough pass his lips and Dean's eyes darted toward him. "Sammy?"

"Jjj…just a cough," he puckered his lips in frustration. He had so much to say and wished he could get it all out but he knew that wasn't going to happen … if he could just write it down, but that wasn't an option either. He reached out a hand and patted his big brother's knee assuring him he was okay. Sam reached up and scratched at his right cheek and plucked at the edges of the tape holding his feeding tube.

"You need me to get Valerie to get you some fresh tape?"

"Later," Sam forced out.

"I know even the cotton tape bothers you when it's been on for a while. I could get her to take it off for a while or …"

"Ddd…Dean stop," Sam smiled. "I'm okay," he garbled out but Dean understood.

"Okay, but I'll get her to change it when we're back inside okay?" Sam nodded. "It's about time for you to eat kiddo. Umm, you know the doc wanted us to think about …"

"Not yyy…yet," Sam struggled. He had been stalling giving an answer to Dr. Finley's suggestion before he'd been discharged from the hospital about keeping his PICC line and starting TPN nutrition, but Sam wanted to keep with the feeding tube for a bit longer, so they had adjusted the rate at which they pushed the liquid nutrition and so far there had been no more vomiting episodes, but they all knew it was going to be sooner rather than later for the TPN IV nutrition and to have another PICC line placed since Sam had had his removed when he was discharged from the hospital. "Ddd…Dean?"

"Yeah, kiddo?" Dean was so happy to be having the short little conversation with his brother today it was more often than not that he was silent a lot, so today was a gift. He almost wished his father were here to have a chance to talk with Sam, too, but he was in town and Dean hoped he'd return with a lead that could help Sam.

"Www…want to sss…stand," Sam's voice sounded so innocent and hopeful even through the slurs.

"Sammy, you haven't walked in a while or stood for that matter, but…" he knew Sam wanted to try and it trying wouldn't hurt him physically because Dean wasn't about to let anything happen to him. He'd hold him completely up if that's what it took for his brother to stand on his own two legs, but it was the potential failure he worried would be just one more hit to Sam. "But, if you want to try I'm willing to help," he smiled and Sam returned the smile. He watched his little brother struggle to look at his big brother and for a brief couple of moments their eyes met and Dean felt his throat spasm in emotion. He swallowed hard, "you ready?" He stood up and locked Sam's wheelchair. Sam nodded.

It was a struggle but Sam stood and Dean held one of his brother's arms across his shoulder and the other around his waist firmly holding him against his side and hip. They leaned on the porch railing. Sam stood on his own legs with a lot of help from his brother but he was up and Dean couldn't get over the sheer look of happiness that was clearly in his brother's face. "Thhhh….thanks," Sam's voice was quiet.

"You're doin' it kiddo," Dean said with excitement for his brother. "I'm just the prop post Sammy, you're standing on your own legs little brother," he smiled at Sam. He felt Sam begin to tremble from the effort. "Maybe it's time to …"

"Minute more," Sam garbled out but Dean understood. He couldn't deny his sibling this simple request.

"Sure thing Sammy, sure thing," he squeezed his brother and held him tight as they both looked out over Bobby's front yard and into the salvage yard from the porch.

**Later that Afternoon**

Dean sat in the kitchen eating a small bowl of chili while Sam slept and Valerie sat with Sam and read a book to herself. John walked into the kitchen through the back door. "Hey," Dean called casually. "You've been gone a while … anything good happening in town?" John sat down and looked at his son with an unreadable expression.

"Maybe," he hedged.

"What!" Dean's voice was quiet but insistent. "There's a lead … you found a way to …"

"Easy, Dean," John put a hand up. "I said 'maybe' and that's a long ways from saying this is fixed. Look until I can find out more I don't want to get our hopes up, okay?" That deflated Dean instantly, if it was a real potential fix his father would be more eager, probably already packing to go get more information, but John wasn't packing.

"What is it?" John shook his head.

"Not important. I'll look into it and if it's real and can save Sammy then come hell or high water I will find this lead," John looked at his first born with determined eyes. "But, for now I called in a couple favors with a friend who is going to look into it for me and let me know what they find out, so I can stay here for a while longer with both of you boys." John would leave if the lead panned out but not until he absolutely had to because he was partially scared he'd lose his baby boy sooner than any help could come and it terrified him to think he'd be away if he could be here as long as possible. Dean nodded.

"We went outside today on the porch and sat for a while," Dean smiled warmly at the memory. "Sammy liked it and he stood a little bit, too."

"Stood?" John looked at his son. "How much were you holding him up?"

"Doesn't matter Dad, he stood on his own two legs support or not," Dean answered easily.

"Yeah, you're right," John conceded. "How was it?"

"It made him happy," Dean answered quietly afraid to say more as he felt his emotions welling once again. John reached over sensing his child's inner battle.

"I'm glad you were able to give Sammy that," he squeezed Dean's right forearm. "I wish I had got to see it."

"Yeah," Dean smiled at his father.

"Is Valerie with him now?"

"Yeah, he's sleeping but he'll be up in a little while for his bath."

Sam had awakened a little while later and Valerie had John and Dean help Sam into the bathroom where she was going to bathe him. The bathroom had been made accessible for Sam and there was a bath hoist installed now that helped Valerie get him into and out of the tub now. They had installed a hand held spray nozzle with scald control on it to prevent any accidental water scalding. Valerie would be leaving in a little over an hour and always liked to see Sam through his early evening bath time after he'd been given his last tube feeding for the night. She would brush his teeth in the morning and at night for him since he could spit the toothpaste out and she would swab his mouth afterward and throughout the day with medicated swabs. She had shown the family how to swab his mouth for him if he wasn't able and his hand control was getting worse, so his personal care was almost completely handled by herself or Sam's family.

Dean, John and Bobby sat in the living room and watched TV waiting for Valerie to finish with Sam, now that they had the bath hoist she could get him out of his chair and into and out of the tub and back in his chair without calling them in to help.

"There you go Sam," Valerie smiled as she dried Sam off with a fresh, fluffy towel. She grabbed a pull-up adult diaper and then put Sam in fresh sleeping clothes. His favorite was a pair of pale dove grey sweats and an old hand-me-down black t-shirt that said _Led Zeppelin 1971 World Tour_ … it had been Sam's big brother's she knew because she had asked Sam and he had smiled and said it was Dean's. Sam whimpered and Valerie looked at him quickly.

"Sam what is it?" her voice soft but determined. "Are you having pain?" He looked at her and she saw him wince slightly. "Sweetie what is it? Am I hurting you?" He shook his head and reddened in embarrassment. She understood, "No worries sweetie you know that … I've got an extra pull-up here and can get you all cleaned up in no time at all," but her mind remembered the wince. She looked at her patient for a moment. "Sam?" His roaming eyes looked at her for a brief moment before they went back to flitting around the bathroom. "Did it hurt when you wet your pull-up?" He nodded.

"Was it pain or a burning, honey?"

"Bbb…burn," Sam slurred out.

"Okay, we'll get that taken care and have Dr. Finley see you tomorrow, okay?" He nodded. "It looks like you might have a urinary track infection Sam but remember we discussed that this could happen, remember?" He nodded. She smiled and proceeded to take the sweats off of Sam and remove the pull-up adult diaper and put a fresh one on Sam and redress him.

Valerie took Sam into his room and pulled a bed hoist over to help get Sam back into his bed. Sam had been frustrated and embarrassed being lifted by his Dad or brother, so Valerie had ordered the hoist for the bed since the bathroom one worked so well for her young patient. "Sam, I'll be back in a minute, okay?"

"K," he answered trying to meet her eyes.

"Sammy good?" Dean stood up as Valerie walked into the living room. "All clean and in his bed. I'd like to call Dr. Finley and have him come out tomorrow and have a look at Sam."

"What is it? What's wrong?" Dean asked quickly his eyes full of concern as he cast a glance toward the hallway and the library where his brother was. John and Bobby both stood at Dean's side.

"Nothing serious," she assured. "I think he may have developed a urinary tract infection or UTI for short. It's burning when he urinates, so I'd like to get that addressed. I'll call Dr. Finley's service before I leave for the night and have them give him the message. This isn't uncommon with PSP patients," she assured. Dean nodded and knew she was right and had read about frequent UTI episodes. "I'm sure he'll prescribe an antibiotic and it should clear it up in a few days."

Later that night Dean sat with Sam and looked at the clock and knew that Margaret, Sam's night care giver would be here in another couple hours to start her shift with his brother. Sam was awake but was having a quiet night and had his head turned toward the window and was watching the sun drop lower behind the tree line as evening approached. Dean studied his little brother and wanted so desperately to know what was going on in his brother's head. There was a hint of sadness in those dark, soulful eyes and it made Dean ache to fix the hurt and take away whatever was bothering his brother. Dean didn't know what he was doing until he was doing it. He lowered a bed rail and slid in next to his brother. He sat higher and put an arm under Sam's neck. He pulled his brother close and looked out the window with Sam.

"Penny for your thoughts little brother," Dean said gently and Sam simply pushed himself closer to his brother and Dean dropped his chin and rested it on his brother's soft chestnut hair … Sam had just spoken volumes to his big brother without a single word. Dean just pulled him closer. "I got ya Sammy, I got ya," and they watched the sunset together.

**To Be Continued **


	10. When the Light Settles Low

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks as always for the reviews and the wonderful PM's. This chapter is around 8 pages long and I decided to spare you a cliffhanger for this update. I still have some more chapters planned but they still need to be written. I hope you all have a good holiday weekend, if you celebrate. Happy reading, I hope!

**So Long, Good-Bye**

**Chapter Ten: When the Light Settles Low**

By Dawn Nyberg

"_How long have I been in this storm so overwhelmed by the ocean's shapeless form water's getting harder to tread with these waves crashing over my head …"_ lyric excerpt by Lifehouse, _Storm_

**Later the Next Morning**

"Okay, Sam," Dr. Finely patted his patients leg. "I'll prescribe something to address that infection and we'll get you back on track, okay? Now, next time you're feeling bad or there is pain when you urinate, please tell someone, alright? If Valerie hadn't noticed your discomfort this could have become much more serious, okay?"

"'K," Sam struggled but his doctor understood.

"Sam, I'm going to have Valerie get a urine sample for me just to make sure, but I'm pretty positive were dealing with just a urinary track infection. I know you've had a catheter before, so you know it'll be a little uncomfortable but as soon as she has the sample she'll remove it, okay?"

Sam nodded. "Good, I'm going to go out and talk to the peanut gallery and let them stop pacing." Sam smiled at that as his eyes desperately fought to look at his doctor. Dr. Finley patted his leg again. "I'll be back in a minute Sam."

Dr. Finley let himself out of the library and closed the door behind him to give Valerie and Sam some privacy as she put the catheter in to get the urine sample. "Well?" Dean stopped pacing and went straight to the doctor. John and Bobby waited, too.

"I'm pretty sure it's a UTI but I'm having Valerie get a urine sample to test and make sure. For most people a UTI isn't a big deal but for a PSP patient they can turn nasty and I want to rule out that a kidney infection is starting." Dean looked alarmed and the doctor smile reassuringly. "Dean, relax, okay? I'm pretty sure that it's a UTI and Valerie discovered it pretty quick. I'll run the sample back at the hospital and I'll call in a prescription at your pharmacy and Sam can start his antibiotic."

"How's he gonna take a pill?" Dean looked concerned.

"I'll most likely prescribe an oral suspension that Valerie can put down the feeding tube with one of his feedings. It'll probably be a drug called Macrobid and she can mix it with a liquid feeding or some milk and put it down his tube. It should be taken with food or milk, so she can take care of it and also show you how to administer it should you have too."

"My son," John began. "You said these infections could turn nasty with PSP patients, is he at risk right now?"

"Sam is at a higher risk for infections due to his condition, yes, especially because of his basically bedridden status, but I really do think it was caught early and I think the antibiotic will do the job."

"But, what if the urine sample says he has a kidney infection, too?" John pressed.

"Well, I highly doubt it as he isn't showing other symptoms that would lead me to suspect kidney involvement but if his sample did show the kidneys were involved then I'd prefer to admit him to the hospital for a strong course of IV antibiotics."

"But, you're pretty sure it's just a UTI?" Bobby stepped forward.

"Yes, I'd say 99.9 percent sure," the doctor smiled at the three men. The library door opened and Valerie emerged with a sealed urine sample cup.

"Here, Dr. Finley," she said as she slid it into a bag and closed it.

"Were there any problems with the catheter placement and removal?"

"Other than being a little uncomfortable, no, Sam did just fine," she assured.

"Good, now," he started and looked back at Sam's family. "I told him I'd stop back inside before I head out. I'll have it tested and have the medication called in today, so he can start on it today, okay?" Sam's family nodded.

"Hey, doc?" Dean stepped forward.

"Yes?"

"How's he doin'? I mean aside from the infection, you examined him, right?"

"If you're asking if I discovered any new advancing symptoms with this visit, no, but Dean…"

"I know, okay," he grumbled. "It's aggressive." The doctor offered a soft smile and reached out and squeezed Dean's shoulder reassuringly.

"I'm going to go say bye to Sam," he left the room and walked back down the hall toward the library.

**Two Weeks Later**

Sam threw a tissue box at his father and brother and mumbled unintelligibly as Valerie tried to calm him. "Dean. John, maybe you should step out and let him calm down," Valerie urged.

"Sammy, it's okay," Dean attempted. Sam had begun having drooling problems over the last couple days or so and although it was a common symptom that happened to PSP patients it was just one more thing for Sam to endure, one more loss of his control and he hated his brother and father seeing him in this state and he hated being like this. He had had a couple incidents of being disorientated and often would wake and think he was back in the car after the semi had hit them, he'd call out for his Dad, slurred and mumbled and then he'd scream for his brother as best as he could, it often was a screech and Dean's name was lost in the slurred, uncontrolled speech. Valerie and Dr. Finley had tried to explain that disorientation and even dementia type symptoms weren't uncommon for PSP patients, but Dean and John still hated it, always fearing that it wouldn't go away. Those episodes had been thankfully transient but the drooling was becoming more common. "Sam?"

"Dean, please," Valerie urged with a strong tone. Sam became rigid and Dean could see a muscle spasm working its way along his bicep up into his neck. Sam whimpered in pain. Dean and John hated the rigid body posture that had begun happening on and off over the last week but Dr. Finley had sadly stated it was just another symptom and that Sam was starting to acquire more symptoms that fit into stage four than three … Dean, John and Bobby all knew that stage four was the last stage and they found themselves wanting Sam to stay in as many stage three symptoms as possible.

"Sam, I'm going to give you something to help with the spasm and pain, okay?" Valerie went to draw up some medication for Sam that Dr. Finley had prescribed for these episodes. "It's okay," she soothed. Dean felt the nausea and the bile creep into his throat. He turned and pushed past his father and went down the hall. John spared a glance at his youngest as his body began to relax and his eyes close from the medication. He met eyes with Valerie and nodded. He left to look after his other child, the other one falling apart just like his youngest but just in a different way.

Dean was on his knees over the toilet as violent spasms rolled over him. John knelt next to his son and rubbed his back as his child emptied the contents of his stomach. "Easy, Dean," John soothed. John stood and handed Dean a glass of water to rinse his mouth when it appeared that his son was finished. Dean sat on the floor and pushed himself back to the wall and sat there. John decided to sit down, too. "Better?" John asked softly.

"Better? Nothing's better dad," Dean answered bitterly. "Sammy's getting worse," he lamented. "Dad, you haven't said a word about the lead in over two weeks," Dean turned pleading eyes toward his father.

"Cole is still looking, okay? This lead isn't exactly easy to locate, if it …" John quieted and looked away for a moment.

"If it what?" Dean pressed.

"Dean, when I know something more I'll tell you," there was a hint of impatience in his voice.

"No, Dad, this is Sammy's life we're talking about here, and we're running out of time," Dean's eyes held a hint of frantic desperation in them. "Please, just say it, okay? It's not easy to locate if it what?"

John sighed, "If it exists at all, alright? This lead, if it exists keeps a low profile but it's our last option. Cole is looking and you know him … he won't leave a single stone unturned. If he finds even a hint I'll go. I'm not letting your brother slip away Dean, not if I can do anything to prevent it." Cole Waters had been a family friend for quite a while, although Dean hadn't seen him in years, he knew that he and his father still kept in contact with one another. Dean looked away as he brushed an errant tear away with angry frustration.

"Dammit," he hissed at the unbidden tear. "Sorry…"

"Hey," John's voice was soft. "No apologies you hear me," he reached out and cupped his child's right cheek and gently thumbed away another tear that had broken free. Dean looked at his father and in that moment he recalled the father he knew before his mother had died and this was that man, he offered a small smile at his father and John returned it warmly.

**One Hour Later**

"How's he doing?" Dean asked softly from the doorway to Sam's room. It looked like his little brother was asleep.

"He's resting," Valerie began. "Dean," she started hesitantly. "I know this is hard, I do. But, please, don't think he doesn't want you around, he's just striking out the only way he can really."

"I know," Dean offered quietly.

"Dean, he indicated to me earlier when I was changing him that," she paused as if trying to steel herself for the rest of the sentence. Sam's communication was hit and miss these days and as of late mostly miss, but he would struggle to make himself understood as best as he could and he had spoken one word today and reached for her hand earlier after she finished pulling his blankets back up after changing him.

"Sammy said something?" Dean looked at her intently. His brother still spoke to them but lately it was few and far between.

"One word," Valerie spoke evenly.

"What?" There was a pause as she met his eyes firmly.

"Hospice," Dean's jaw clenched and Valerie could see the muscles tightening. She watched his eyes dart toward his brother's sleeping form and she saw the agony in them. He shook his head ever so slightly.

"Not yet," Dean's voice barely audible.

"Dean, you're never going to be ready for that day, it will always be 'not yet,' she offered as she put a hand lightly on his forearm.

"He doesn't need a place like that," Dean started, keeping his voice low. "He can have that care here, right? I mean he doesn't have to go, right?"

"No," she offered easily. "But, it's what he wanted when it came down to this … Dean, the disorientation could become worse," she started. "You've read the literature and you know that often hallucinations begin, as well. He doesn't want to subject you and the rest of his family to that, and now with the drooling and the continued communication problems. There will come a time, I fear much too soon that he will not be able to speak at all. You know he's likely to withdraw even more."

"I know, okay, I've read all the information, I know … you don't think I haven't noticed that he can't even watch TV anymore, it's like his attention span is almost gone and he can't keep his eyes on anything except for the rare couple seconds or so, but he likes music," Dean added quickly. "He can still smile and I know he likes for me or my Dad and Bobby to sit and talk with him even if he can't look at us or talk."

"Of course, he likes having you nearby and loves for you to talk to him. He's still in there Dean, he's still every bit your little brother, but his brain is betraying his body. He doesn't want you to have to wake up every morning to knowing that he's in this room and …" she paused and decided she needed to say it for Sam, "Dean, I think he most fears passing away here because it will always be with you and he doesn't want to take this place away from you. He wants you to remember the good times here not his death. Dean, there may be some morning when he looks at you and doesn't even know you for a second or so; he wants to spare you that." Dean turned away as he felt hot stinging in his eyes. He took a breath and turned around facing Valerie again.

"It doesn't matter if he's here or at a hospice," his voice grabbed. "I'll remember everything anyway. He should be here and not some place with strangers and it's not like I wouldn't be there every minute anyway," he reasoned.

"You agreed to his living will Dean," she said gently. "You'd take that decision from him, one he made when he could still express himself." Dean shook his head sadly.

"No," his voice shook. "But, it's not time. I'll talk to him."

**Later that Day**

Valerie had excused herself for a break and Dean wanted to talk to his brother. He walked in and closed the library doors behind himself. He carried a brown envelope with him. Sam watched him enter and his eyes roamed around the general direction of his brother. Dean sat down on the side Sam was laying. "Sammy, we gotta talk, okay?" Dean reached for the terry cloth towel near Sam's head and gently wiped the drool from his brother's chin and cheek. He could see his brother tense. "Easy, Sam, see all dry, no worries." He opened the envelope and slid a manila file out and put the papers on the rolling bedside table. "This is your stuff," Dena started and stopped, he took a breath, "I mean your living will and a copy of your advanced directives for the hospital. My medical power of attorney is here, too," he fought to keep his voice level and without tremor.

"Val, told me you mentioned the hospice today, that true?"

Sam nodded.

"If you still want to go after I'm done saying my peace then I'll find a place, but you hear me out first, deal?" Sam hesitated. Dean reached up and grasped his brother's arm. "Deal?" he said once again.

"Ddd … llll…" slurred out but Dean knew what his little brother was saying. He smiled reassuringly.

"Good," he let his hand settle on his brother's right calf that was covered up. "Look, I get why you think you have to go to a place like that Sammy, but you're not protecting Dad or me from anything … you'd just make us worry even more. I'd just stay with you practically 24/7 anyway," he stated flatly. "I want you here, Dad and Bobby want you here for as long as you can be … I get that you might need some extra medical care that can't really be done here and then a medical facility would be needed, but a hospice Sammy … you belong here and not in some place with strangers."

"Nnn … tttt… ea ….y … tttt ooo hhh…hard fff…for," Sam stopped and tried to concentrate. "Too hard fff…for you and Dddd…dad," he struggled out. Dean looked at Sam with intense eyes.

"You're worried about this being too hard on Dad and me?" Dean gently squeezed his brother's calf. "Sammy, this isn't easy for any of us and it isn't this," he motioned to his brother's bedridden status and even waved the cloth towel that he reached for yet again to wipe a bit of saliva as it escaped his brother's mouth. "Taking care of you no matter what, it's what family does for one another. It's not easy watching you try to be strong for us and it's not too hard Sammy," Dean tried to make his sibling understand.

"It would be too hard if you weren't here Sammy … I'll honor your wishes I will, but, please reconsider and stay here at Bobby's," Dean's voice had an almost begging quality to it. "I read over your advanced directive for the hospital," he admitted with a little sadness. "I, ugh … gotta admit Sammy that I never really got all the way through it before 'cause I couldn't sit there and read how you wanted to …" his voice shook now and he stopped. He took a breath, "I couldn't sit and read how you wanted to …" he just couldn't say it.

"Die," Sam slurred out and Dean looked at him.

"Yeah," he admitted. "But, I read it all today. I knew about you not wanting a surgical feeding tube but I read the stuff about how you want the vent removed if you have no chance of recovery and that about all of the heroic measures stuff … I know you agreed to IV hydration and nutrition and pain relief … I get that you don't want to be stuck on machines, okay?" Dean sighed. "I promise I'll do what you want and I won't fight the doc in obeying your wishes."

Sam reached out and placed his hand where he felt his brother's hand resting and he took hold if it and squeezed. "Thh…thank you," he garbled out.

"Don't thank me Sammy, I don't want thanked for this. "So, you'll stay no hospice?"

"Fff … for now, bbb…but…"

"I know, if it comes to it … I mean you get sicker or you go into the hospital and they say there isn't anything they can really do you want to go, right?" Sam nodded. "So, you'll stay?"

"Yyy…yes … fff…for now."

Dean looked at his watch, "Look at the time Sammy, it's about time for a feeding. The doc added some more supplements for you to start taking, I'm gonna let Valerie back in here and I'll get your stuff ready, okay?" Sam nodded.

Sam watched his big brother leave the room and despite not being able to really keep his eyes on him he could see the sorrow that hung heavy on Dean's shoulders and he blamed himself for that burden but he now understood that staying here until he absolutely couldn't any longer was what his big brother needed, so he'd give him that, he'd give him as much as he could. He raised a shaky hand in an attempt to wipe the saliva he was just now realizing had begun to slide across his jaw line. "Here Sam," Valerie's voice was soft. "Let me help you with that," and she picked up the towel and cleaned off Sam's face. "So, you and Dean have a good talk?" she asked lightly. He nodded. She smiled. "Good."

Dean stood at the kitchen counter preparing the syringes with the liquid feedings that Valerie would hook to the port end of Sam's NG tube. His brother took two large syringes for his liquid feedings and supplements. His hands were shaking as he capped the last one. His mind reeling from the conversation he'd just had with his baby brother … Sam dying wasn't an option and the thought of his brother not being here anymore suddenly overwhelmed him. He began to shake but before he could lose complete control he felt a hand on his shoulder and he turned and looked into his father's eyes. John had been outside most of the day helping Bobby with a transmission problem. There were no words … John gently took the syringe out of Dean's shaking hands and placed it on the counter. He looked Dean in the eye and offered a warm, silent smile, there wasn't anything to say, no fatherly advice or words of support that were going to help, so John did what made sense, he pulled Dean into a hug and held his son.

**To Be Continued**


	11. Memories like Sand

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks for the reviews and PM's, they are all appreciated! This past week has been insane for me, but I managed to get a chapter written for all of you. It's around 5 ½ pages long. I still have more chapters planned that still need to be written, but I'll get there. Slow and steady might not win the race but at least you get to the finish line. I will try to post another chapter next weekend at some point.

Happy Reading, I hope!

**So Long, Good-Bye**

**Chapter Eleven: Memories like Sand**

By Dawn Nyberg

"_Never really said too much afraid it wouldn't be enough. Just try to keep my spirits up when there's no point in grieving. Doesn't matter anyway words could never make me stay words will never take my place when you know I'm leaving … try to leave a light on when I'm gone, something I rely on to get home, one I can feel at night, a naked light, a fire to keep me warm …"_ lyric excerpt by David Cook, _Light_

**June 10, 2006, Bobby's place**

"Dean," Valerie spoke softly. "It'll pass, okay?" she tried to assure Dean that his brother would recognize him when he woke up from the mild sedative Dr. Finley had prescribed since the episodes of disorientation had increased over the last couple days. It had been just a little over a week since Dean had had the conversation with Sam about not wanting him to go to a hospice any sooner than needed and it seemed each week there was something else to cope with for Sam and the entire family.

"He looked at me and didn't know me Val," Dean looked at his sleeping brother. "He was calling out for me and he didn't know me, my voice when I tried to tell him I was there."

"Dean, he was disorientated," she assured. "The episodes may get worse, lessen or stay about the same, it's a horrible thing but just know that on some level he knows you, okay?" Dean nodded. Sam had hallucinated one or twice over the last week and he was difficult to control and was quickly sedated before he hurt himself. A few slurred and garbled words would make it past his lips on occasion when he hallucinated about demons and ghosts and Dean, John and Bobby had just said he had been into mythology and lore and was a horror movie watcher. Valerie had heard patients say a lot of strange things when they hallucinated; she had assured the family that she wasn't put off by Sam's hallucinations.

"D'n," the slur was thick but the word, the meaning unmistakable. Dean looked at his brother and Sam had turned his head and although his eyes weren't on him he knew his little brother knew he was there. Dean smiled and Valerie gave a soft smile.

"Hey, little brother, how ya feeling? Have a good nap?"

"K," Sam offered as best as he could.

"Hey, Sammy, I thought you might like to go outside again and get some fresh air and sun," Dean grinned when Sam managed to meet his eyes for a moment and nodded. "Okay, kiddo," Valerie stepped forward to help get Sam in his wheelchair. The bed hoist was a big help and reduced a lot of stress for Sam in the transferring process. "Thanks, Val," Dean replied with a genuine smile.

Dean sat next to his brother on the porch. He had picked his brother up and put him in a regular chair not wanting Sam to sit in his wheelchair the entire time. Dean's mind rolled through many thoughts as he sat with his brother. He knew the symptoms were getting worse but he also knew that the symptoms themselves weren't going to take his brother from him but it was the condition itself made his little brother susceptible to infections and other complications, so if they avoided all of that there was still time to save him, so he tried to keep that thought at the forefront.

"Feels good out here, huh?" Dean reached over and patted his brother's leg.

"Mmm," Sam replied with a contented look on his face. Dean took comfort in that and was happy that his sibling could still find something pleasurable. The screen door creaked behind them as it opened and Dean looked up.

"Hey Boys," John's voice was light. "How ya doin' today kiddo?" He asked Sam as he rested a hand on his son's head and allowed the soft chestnut strands to move through his fingers. Sam offered up a small dimpled smile. "That good, eh?" John replied and lifted his hand and sat down. "I hope you boys don't mind a little company…"

"K," Sam forced out. John nodded. Dean didn't bring up the lead anymore but he had overheard his father on the phone late the previous evening with Cole and he knew something was brewing but his father hadn't indicated he was leaving, yet, but the signs were there or at least Dean thought they were but he was afraid to ask and decided to wait until his father said something.

**Two Days Later**

Dean looked up as Valerie walked into the kitchen. "Dean, I need to call Dr. Finley about Sam."

"What's wrong?" Dean's brow creased in concern. Sam had been okay he thought. Quiet the last day or two but okay.

"Margaret mentioned to me that she noticed him grimacing in his sleep the other night but he didn't wake up and she thought it might have been a nightmare…"

"And…"

"He's having painful urination again…" Valerie offered. "I also think he's having some lower back discomfort, as well.

"Another UTI?" Dean questioned. He noticed the small bit of tension in Valerie's eyes that made the hair stand up on the back of his neck. "What?"

"He has started running a low grade fever and I just changed him and there was some evidence of blood in his urine." Dean felt his world collapse inward.

"Oh God," his eyes darted down the hallway. "I'll call an ambulance," he started to turn to get the phone and his brother help. Valerie placed a calm hand on his shoulder and stopped him.

"911 isn't necessary Dean. I'll call Dr. Finley, I'm sure he'll send a transport unit and will admit Sam to the hospital for a few days. I think he may have developed a kidney infection but the doctor will do some tests to make sure. Let me call him. Sam isn't in immediate danger this very moment but if Dr. Finley wants an ambulance we'll get Sam whatever he needs but there's no need to get him all worked up with paramedics rushing around," she reasoned. Dean nodded. "Go sit with Sam and I'll call the doctor, okay?" Dean didn't have to have her say it twice he went to his brother without further preamble.

**Two Days Later, Greene Memorial Hospital, 3 NE Unit**

"Dad?"

"Yeah?" John looked over at his oldest son. They had been sitting with Sam in his hospital room but his youngest was sound asleep.

"Look, I wasn't going to ask but…" Dean hedged.

"Cole is zeroing in on a location, okay? Once he finds what I'm looking for, he'll call and meet there," John didn't elaborate further.

"Dad, what is it?" Dean needed answers … this was Sammy, his brother's life.

"Dean, I'd tell you I would, but this was something Cole mentioned, something he believes exists, but if this _possible_ lead does exist their kind keep a low profile once they come of age apparently, but no hunter has ever encountered one …"

"Sp whatever this is … if no hunter has ever encountered this," Dean left it hanging for a moment and started again, "this thing, person, whatever … then why do these _whatever's_ keep a low profile?" John couldn't help but allow a mild grin cross his face. His first born was tenacious and sharp.

"Let's just say that the supernatural world apparently doesn't like their kind, if they exist and are hunted, and killed." Dean looked at his father with confusion.

"Killed, by what? I mean if the supernatural world wants to hunt them then you're saying evil wants them dead and what? Good, too."

"Look if they exist," John wanted to end this conversation before Dean latched on too tightly just in case it was another dead end. "They are considered an abomination, okay? Leave it at that son, I'll tell you more when I can but not before, alright?"

Dean sighed and nodded. He let it drop for now. He turned his eyes back to Sam and was glad that the fever flush of the last couple days had finally gone away and that the antibiotic IV therapy was working toward clearing up his brother's kidney infection.

A voice cleared itself at the doorway and John and Dean both looked up. "Hello men, I thought I'd stop by on my afternoon rounds."

"Hey, doc," Dean said with a small smile. "Sammy's still sleeping."

"I don't need to wake him. I saw him earlier and his latest test results are showing some improvement regarding the acute pyelonephritis," he smiled and readjusted his wording, "sorry, I meant his kidney infection. Due to Sam's PSP diagnosis, I'd like to err on the side of caution with the IV therapy. As I stated when he was admitted the Cipro IV therapy usually lasted 7-14 days, I'd like to keep him on the full 14 day course."

"Whatever, Sammy needs Doc, I just want him well and to take him home." The doctor nodded.

"He is responding to the therapy and I expect him to be able to return home when the IV therapy is complete."

"Thanks doc."

"Dr. Finley," John kept his voice low as not to wake Sam. "You mentioned that my son's infection was acute and not chronic, and that it was a positive thing that it was acute, but I've been reading the literature and is it possible that his condition could become chronic?"

"John," the doctor began tentatively. "With PSP patients it's always a possibility but he is responding to the therapy and right now his condition is of an acute nature which is treatable and good news for Sam because I don't see this as a life threatening episode. Sam is more prone to infections now with this disease but so far we are managing them and he is tolerating things as well as can be expected. I understand the home physical therapy visits have helped a lot with his restless legs at night and the cramping. Valerie and Margaret both forward copies of their care and progress notes to me."

"It does appear to help," John offered. "Is there more we could do for him?"

"John," Dr. Finley smiled. "You, Dean and Bobby have been wonderful with Sam and there isn't anything more to do. You get him outside, he has therapy, and you keep him stimulated with music and conversation. I know that TV shows and movies on TV have begun to be too difficult for him to watch and the stimulus is a bit over loading to him, but Valerie sings your praises … she says you're all great with him."

"Dean keeps on top of things," John smiled at his oldest son. "He's always been there for Sammy and for me." Dean dropped his eyes in embarrassment at the impromptu praise from his father.

Sam stirred and all eyes turned to him. "Hey, Sammy," Dean smiled. "You feelin' okay? Any pain?"

Sam shook his head as his eyes roamed around the room. "Nnn…Nnnnoooo."

"Good," Dean assured. "Hey, look who came to see ya Sammy, the doc is here."

"Hi Sam, just checking in and things are looking good. You'll be back home in a few days, okay?" Sam offered a small lopsided smile and a small amount of drool slipped out as he spoke.

"Gggg…Goooood." The word slurred and seemed to stretch out but he made himself understood. Dean reached up gently with a moist cloth and wiped the drool away and dried the wetness with a dry corner from the cloth.

Later that night John had returned to Bobby's to make phone calls and Dean had stretched out on the chair that reclined to a small bed. He fluffed the flat hospital pillow and pulled the blanket over his chest. He was glad that although the room had a bed for another patient that right now Sam didn't have to share with another person. Dean looked over at his brother in pale light from the hallway and the small amount of moonlight that crept in through the pulled shades. Sam looked so much younger than his twenty-three years. Dean felt his throat constrict in emotion. He felt compelled to touch his brother and crawled quietly out of his makeshift bed and approached his sibling's bedside.

He reached down and gently brushed the long chestnut bangs from Sam's forehead. It was a soothing action he'd done for Sam when he was still little. The emotions bubbled once again and he couldn't find a voice, so he merely smiled down at his brother, his eyes welled and a single tear ran unchecked down his cheek. He took a breath, and spoke quietly. "Sweet dreams Sammy, I'm here, okay?" His voice was quiet but even in sleep Sam sighed and turned into his big brother's touch.

Dean returned to his makeshift bed and watched his brother in the pale light until sleep claimed him. His only thought; his only focus, _you can't go, Sammy_.

**To Be Continued**


	12. All Apologies

Disclaimer: refer to chapter one

**NOTE TO READERS: **Okay, I apologize for not posting last weekend but things are very hectic on my end and I just couldn't do it, sorry! Thanks as always for the kind PM's and reviews, they are all appreciated. This chapter is around 9 pages long, so at least it's not super short. I still have some more chapters planned but the finish line is coming into sight. Happy Reading, I hope!

**So Long, Good-Bye**

**Chapter Twelve: All Apologies**

By Dawn Nyberg

"…_I know you didn't bring me out here to drown, so why am I ten feet under and upside down, barely surviving has become my purpose cause I'm so used to living underneath the surface …"_ lyric excerpt by Lifehouse, _Storm_

**Greene Memorial Hospital, Day Ten of IV Treatment, Sam's Room**

"K, D'n," Sam forced out.

"Look Sammy, I know you want out of her man, I do, but the doc says you got to finish the IV antibiotics first, okay? Look the infection is clearing up but we gotta make sure and the doc says you need the full 14 days, okay?" Dean could see the disappointment in his little brother's eyes but at least his eyes were clear and not glassy with fever like they were for the first couple days he was in the ICU. Sam was in a regular room now but Dean still felt like he was on high alert waiting for the other shoe to drop but Sam was holding his own and doing better with the IV. Their father was still in town but he was stepping out for hours at a time now since Sam was out of the ICU. Dean could feel something was on the horizon and he forced himself not to feel the hope that was burning so badly to be released … hope that their father was going to fix this, and save Sam.

**Later that Day**

"Dean?" Dr. Finley spoke from the door threshold to Sam's room. His patient was clearly sleeping and he was glad the sleep appeared restful for the young man.

"Yeah, doc?" Dean stood up quickly keeping his voice quiet in order not to wake his sibling. The physician motioned for them to step out in the hallway. Dean felt his stomach clench in response. His eyes were intense when he prodded the doctor quickly. "What is it? Is it Sam? Is the infection worse? What?"

"Easy, Dean," the doctor tried to assure but Dean could see something in his eyes.

"But there's something, right?"

"I know this is a sensitive topic for Sam but we're at that point now …" Dean wasn't sure where this conversation was headed but he began to feel nauseous.

"What point? You said he's responding to the medicine," Dean's voice shook.

"His nutrition Dean, he really needs to consider the TPN if he still refuses the surgically placed feeding tube."

"Can't we supplement more through his NG tube?" Dean questioned.

"He needs more Dean and he's lost over fifteen pounds in the last month and half. He was already lean with a lot of muscle when he became ill but he's bedridden mostly except for when he's in his wheelchair. He's losing muscle mass and he had little fat to start with … he needs help Dean. The physical therapy is helping his muscles not completely atrophy, but he's edging into malnourished. You and the home health care staff have done an excellent job but the NG tube just isn't getting the job done." Dean rubbed a hand across his tired eyes and then ran it over his hair.

"I'll talk to him, okay?"

"I'd like an answer today," the doctor stated.

"What if he says no?"

"Then we'll do as much as we can with the NG tube and may initiate some home IV treatments to supplement his feedings that aren't a TPN. I don't think I need to say this Dean, but you need to hear it … the weaker his body becomes from lack of proper nutrition the more his immune system is going to break down …"

"You mean he might make himself open to other infections?"

"Yes, but unfortunately with his advance directive on file and a copy of his living will is on file as well with our hospital, if he declines, additional treatment cannot be reinforced. He made his wishes clear when he still possessed all of his faculties and could verbally communicate effectively."

"But, I have his healthcare power of attorney," Dean pushed. "If he needs something that is medically needed I can okay it, right?"

"Only if it is within the allowances of his directive, Dean. The hospital must honor the advanced directive. It's a legal document."

"I know, okay," Dean hissed. He was angry and scared, a bad combination for a Winchester, let alone a big brother in full protect mode. "Can I take a look at his directive again? I've read his Living Will but I admit his directive I've skimmed. I figured it didn't say any more than his Living will."

"Sure I have a copy attached to his medical file at the desk. There is also another copy on file in Hospital Legal Services Department. Are you looking for something?"

"Maybe, I just want to see what Sam put in there. I know there were some revisions after I witnessed and then he used a nurse during that one visit."

"Here," Dr. Finley handed the paperwork over. "There are pre-filled in options but Sam opted to fill in the area that allows for more specific items. Of course, they were formalized a little with the legal department during the revision Sam had wanted," Dean nodded and read over the special instructions/wishes section:

Should I develop a life threatening infection due to my condition that is not responding to treatment and there is no chance for a meaningful recovery (definition of meaningful: that I can return home to continue receiving home care); I wish to have pharmaceutical interventions ceased and nature allowed to take its natural course.

If I am placed on a ventilator and my condition is such that I will not be able to sustain my life without artificial respiration; I wish to have the ventilator support withdrawn.

Should my heart stop beating due to a complication that I could recover from I wish to have CPR and advanced life support, however, if it is due to the withdraw of treatment or the arrest is part of my disease process and there is no hope of meaningful recovery then let my life end naturally and do not attempt to prolong my death.

It is my desire to have my nutrition needs met by NG tube and/or mouth (if able to swallow safely). I do not want the surgical placement of a feeding tube at any time.

I desire IV hydration should it become necessary, so that I may be kept comfortable.

I request to have any pain and any anxiety controlled by any means deemed medically appropriate (i.e. IV medication, PCA pump, pain patches/solutions/injections).

Dean wanted to be sick but he took a deep breath and focused on the words, his little brother's wishes. He had to find a way around Sam if it came down to it. "Here," Dean pointed.

"What?"

"It says he doesn't want a surgical tube…"

"Yes, but what are you getting at?"

"He hasn't written down express wishes to refuse a TPN. He says nothing about IV nutrition."

"Dean, it's splitting hairs," the doctor hedged.

"Look, I'll talk to him, but he hasn't written it in his directive. If he had, I'd respect it. I wouldn't like, in fact I'd hate it, but I'd respect it, but he didn't write it down."

"But, he's said to the best of his verbal ability Dean that he won't approve the TPN."

"Then knock his ass out and hook him up, he'll never be the wiser … juice him up, and pull the IV before you let him wake up. Prescribe some IV's that can supplement the tube feedings he gets at home … there has to be something. I'm not losing him because he's not getting enough nutrition through his tube. I never agreed to let my brother essentially starve to death." Dr. Finley could see Dean's determination. He shook his head.

"It's not that simple and certainly it'd be unethical," he mumbled under his breath and rubbed his face in frustration. "I can't…"

"I said I'd talk to him, look if you won't do it, then isn't there something you can prescribe; send him home on an IV … anything to help?"

"There are some options, but…"

"But, the TPN is best…"

"Well, honestly, Yes and no," the doctor scrubbed a hand over his face once again."

"What'd you mean?" Dean's eyes were intense.

"Well, the TPN can be a lifesaver but it's a double-edged sword Dean. It's not easy on the organs that are involved in digestion like the liver, gall bladder; pancreas … sometimes the organ damage is severe enough to warrant transplantation. He'd have to have frequent blood tests to monitor his body's reaction to the TPN. Plus, it does leave his bloodstream open to potential infections although great care is taken to avoid that…"

Dean shook his head, "Okay, what else is there … Sam's not strong enough for that crap. Organ damage, please there has to be something."

"I'll talk with our clinical dietician and try to come up with some alternatives and nutritional formulas, okay? I'll go talk to her now and I'll see you both later." Dean nodded.

"Thanks, doc," he offered the physician a soft smile.

**Four Hours Later, Sam's Room**

"Sammy, I was talkin' to the doc earlier while you were sleeping," Dean started and watched Sam make an effort to look at him as his eyes fought to stay on his big brother for a few moments. "He says you're losin' to much weight kiddo and you can't afford it. He says your immune system is going to start suffering soon …"

Sam wasn't stupid he might be trapped in his body and stuck with a brain that he had to fight tooth and nail to get to do what he wanted but he knew where Dean was headed with this conversation. He shook his hand at his brother. "Nnnooo," he slurred. "Nnnoo, T … P … N…" he forced out to make himself understood. Dean sighed.

"Yeah, it turns out as good as the thing is it might not be that great for you Sammy. Look, I'm having the doc look into some other nutrition stuff for you … how about we avoid the TPN but would you be willing to try some IV's and maybe some additional tube feedings or something?" Dean was grasping straws and needed his brother to agree to something, anything to keep him here, alive. There was a long silence and Dean watched his brother's wheels turning in his head. "Sammy, I can't watch you starve to death, please Dad and me we can't …"

"I … V… oookay," Sam struggled. "Mmm…more fff…feedings, Okay," he garbled out. Dean smiled and reached over and let his palm flatten on his little brother's chest and patted it gently.

"Thanks Sammy," his voice was soft as he fought the emotion grabbing his throat muscles. He patted once more and made light of the situation, "we'll put some meat back on that bean pole body of yours in no time." Sam offered his brother a small lop-sided grin and met eyes with him for a few seconds. That brief moment meant everything to Dean.

**Two Weeks Later, Bobby's House**

Sam's room in the library looked more like a hospital room. There was an IV pole that supplemented certain vitamins for Sam and Dr. Finley had instituted a modified tube feeding called Enteral Nutrition. He had explained to Dean that Sam would still be getting his feedings by the NG tube in his nose but now his nutrition and various supplements were in a large bag that administered the tube feed solution over 8-24 hours and they did it in the evening while Sam slept. Dr. Finley and the dietician felt that Sam also required mid-day feedings, too. So, Valerie would administer intermittent gravity drips of feed solution over 30-60 minutes over lunch time. It was a modified solution as to not overload Sam with certain supplements. He was also allowed to have bolus feedings once or twice a day as needed that were administered over 15-20 minutes.

Sam had begun sleeping a lot the last week but he seemed to be awake in the afternoons and Dean wanted to spend every moment he could with him. Sam had trouble moving himself and needed help turning in bed to avoid bed sores. He could still manage a word or two when he wanted and once in a blue moon a fractured sentence which Valerie had said at this late stage was a rare gift. Their father had packed a bag and left a couple days ago. He was meeting Cole to follow a lead to a potential location but he hadn't said anything other than to call him if Sam got worse or something happened. John had been straight with Dean and Bobby. This potential location may not pan out but John just simply felt like he had to do something, so he was going with Cole, but if the location didn't pan out he intended to come home and wait until Cole knew for sure where to locate what they needed, what Sam needed.

"Hey Sammy, it's nice out today you want to go outside?" Dean looked hopeful but Sam shook his head lethargically and Dean cast a worried look to Valerie. She simply offered a slight supportive smile. "There's a nice breeze outside Sammy. Just the kind of weather you like." In the last week Sam had preferred the bed over his wheelchair and he was no longer able to support his weight on his own legs at all anymore. Valerie had said 'spaghetti legs' as she called them were common in late stages of PSP. "No?" Dean tried to keep his voice even and not show the disappointment but it was hard. Sam just shook his head slowly and closed his eyes turning into his pillow and was asleep quickly. Valerie reached out and nudged Dean and then motioned for him to step outside so she could talk to him.

"Dean, it's not you," she assured. "Unfortunately, in stage four of the disease process PSP patients … they sleep more and just want to stay in bed, but make no mistake he loves having you nearby and to have you talk to him. He's still in there Dean but it is not uncommon for patients in this stage of the disease to become withdrawn. The new feedings have helped," she felt compelled to give Dean some good news. "He gained a little weight back," she left it open without a number hoping Dean didn't ask knowing that the small number that it truly was would deflate Dean even more. He didn't ask but just offered a small smile of gratitude to the woman helping to care for his little brother.

**Bobby's House, Two Weeks Later, July 4, 2006**

Valerie had started her morning shift an hour ago and grabbed an adult diaper to change Sam. He was still sleeping and she hadn't wanted to wake him. Margaret the evening nurse had said Sam hadn't indicated he needed changed all evening and she had decided to let him sleep because he had been restless. Valerie looked at the care notes once again:

Sam had a restless night and appeared to have some grimaces now and again but mostly he had a quiet night. There was no indication that he needed a diaper change. I did check once while trying not to wake him anymore than necessary and he was dry. The evening feeding went well and the full bag was infused. IV hydration was completed, as well. There are additional nutrition notes under the feeding schedule….

Valerie quit reading and closed the library door. This was what she did that let Sam's family know that he was being changed or some other sort of daily care was being done and it allowed Sam the privacy and dignity that he deserved and wanted. "Sam?" her voice was soft and she made an effort not to startle him. "Sam, time to wake up," he stirred at her voice and opened his eyes. "Good morning sleepy head," she smiled warmly. "Let's get you changed kiddo, okay? Start the day off fresh. You've had a lot of fluid over the last few hours, so I bet it's time." She proceeded to removed Sam's evening diaper and stopped. She took her gloved hand and pressed on the used diaper, it was dry. She frowned and looked at her patient. "Sam, do you feel like you need to go? Are you uncomfortable?" He reddened and turned his head away.

"Sam, this is important," Valerie encouraged softly. "Margaret said she didn't think you needed changed last night and you were dry when I left yesterday and turned the shift over to her. Sam?" He nodded and pulled at the sheet to cover himself. "I'm sorry sweetie, here," she answered quietly as she pulled the sheet over his exposed body. "Sam, do you need to go and you can't?" she questioned. She watched Sam's eyes well and saw one hot tear roll down his cheek. "Hey, it's okay honey, I'm going to help, okay?" She walked over to a cabinet they had been using to store medical supplies for Sam and she knew she had some catheters and urine collection bags in the event they were ever needed. "Sam, I have to put in a catheter to help you empty your bladder, okay?"

She inserted the catheter and hung the urine collection bag at the bottom of the bed on a small hook designed for this use. The catheter was doing its job and she saw urine freely flowing into the bag. "Sam, I need to keep that in for a bit, alright?" He nodded. They had been dressing Sam in hospital gowns for a couple weeks now because it was easier to care for him now that he couldn't do much of his daily care anymore. "Hey, how about we brush your teeth, huh? Get rid of the morning grunge?" She knew Sam loved to have his teeth brushed because it was the only time other than when his mouth was swabbed with oral care swabs that he actually was able to taste anything, to feel human. He could still swish the cold water around and spit into a basin, although his spitting had slowly become more of a lean over the basin and let it fall out. She always made sure the water was clear before she had him stop rinsing.

A short while later, she put away the toothbrush and walked over and brushed Sam's hair. "You know my husband used to have hair like yours when we met," she mused. "He says he's thinning out a little," she laughed. "I call it bald, but I love him anyway." Sam smiled at that and moved his lips to try and say something but it came out as a garbled hodgepodge of indecipherable words. "Sam, it's okay sweetheart," she assured. "Maybe, later the words will work for you, just be patient, morning are a little rough at the start for you, remember?" she knew he was frustrated and she wished she could do something more for him but being there for him and helping him understand what was happening to his body, his mind was what she could do and most of all she could be there for him and his family. She had may have one bedridden patient but in reality she had three other patients, as well, Sam's family. She leaned over and looked the collection bag and her eyes she did a double take. She looked at her watch and consulted her notes on what time the catheter was placed and she noted that in just a little over an hour she had collected 1400cc's, her mind thinking one thing, Sam was experiencing urine retention. "Sam, I need to make a phone call, alright? How about I let Dean know we're all done in here?"

Sam nodded and she opened the library door. She walked into the kitchen where Dean and Bobby were sitting with their morning coffees. "Hey, Val, all done with Sammy?" Dean smiled at the nurse.

"Dean, I put in a catheter, so Sam could empty his bladder," she decided cutting to the point was best as she wanted to call Dr. Finley.

"What? Why? He just goes in his …" his voice drifted off. He hated saying diaper.

"He's experiencing urine retention, but it can be handled with a catheter. I placed it just a little over an hour ago and then finished with out morning routine and the urine bag has collected 1400cc's."

"Is that bad?" Dean felt his heart begin to pound against his sternum.

"It just means he's been holding for a while Dean. It's a lot of output for such a short amount of time. His bladder was very full. I'm going to call Dr. Finley and see what he'd like for me to do. He may come to examine Sam or ask us to bring him town. He's okay Dean, he's not in any pain now that his bladder is empty and I told him I'd send you in, so you can see him. He nodded to let me know he wants you in there," she grasped Dean's forearm and gave a reassuring squeeze."

"If he needs to go to town, let me know, I can get the car ready," Bobby chimed in. There were preparations to make whenever Sam went out that made his travel as comfortable as possible. Valerie nodded and went to the phone.

**Meanwhile, Greene Memorial Hospital**

Dr. Finley had been paged that he had a phone call, so he went to his office to answer it. "Hello, this is Dr. Finley."

"Dr. Finley, this is Valerie, Sam Collin's care nurse…"

"Hi Valerie," he offered amicably. "Is there a problem with Sam?" he sat a little straighter in his chair. He had become fond of the young man and it seemed whenever Valerie called there was a problem.

"I had to place a catheter this morning because it had become obvious that he hadn't urinated in a few hours and he was showing a little discomfort in his sleep. In a little over an hour the output was 1400cc's…" she heard a sigh on the other end of the phone.

"Sounds like he has some possible urine retention happening. I'd like to see him and unfortunately I think this warrants an office visit where I can fully check him out."

"I thought you we're going to say that," Valerie replied. "I'll get him ready and we'll be there soon."

"They'll page me when you get here. It's a light day but it is July 4th so I expect things to pick up later tonight, but right now things are pretty open, so we'll get Sam right in," he never tried to make Sam wait in the waiting room long because it appeared that the more advanced the PSP became the more he was upset by too much stimulus, loud noises, crying babies, so he tried to make his trips as comfortable as possible.

"Thanks." Valerie hung up. "Bobby?"

"Yes?"

"He wants us to come in…"

"No problem, I get the car ready."

"How ya feelin, kiddo?" Dean asked and reached over and caressed his brother's cheek with a thumb. Sam leaned his head into the touch and Dean felt his chest tighten. He couldn't help but notice the urine collection bag and could see that it was a little over 1400cc's now but just barely. "So, Val tells me we might have to go see the doc today to get you fixed up, so you don't have to keep this catheter in … how's that sound?" He placed his hand in his brother's a Sam squeezed it and Dean knew he understood.

"Hi Guys," Valerie kept her voice light. "Well, I guess we're going on a field trip to see the doctor in town. He's expecting us," she assured. "Dean could you step out while I remove the catheter … I'm not keeping it in for the trip."

"Yeah, sure, I'll just be outside Sammy," he assured as he left the room. The door closed and Dean leaned his head against the thick wood, his heart in his throat and fear slivered up his spine causing him to tremble for a moment. This wasn't a bad sign … he had to believe that … this was another easy fix like the UTI … should he call their dad, his mind reeled with thoughts … he pressed the palms of both hands against the door and closed his eyes for a moment and pushed his fear back into its cage for now.

**To Be Continued**


	13. Letting Go in Inches

Disclaimer: refer to chapter one

**NOTE TO READERS: **Thanks again for the reviews, PM's and personal emails you've been sending. They are all appreciated! This has been another hectic week for me and I was doubtful I'd get a chapter ready for all of you but here it is for better or for worse. This chapter is around 7 pages and this story has another 2-3 chapters left before it's finished. Happy Reading, I hope!

**So Long, Good-Bye**

**Chapter Thirteen: Letting Go In Inches**

By Dawn Nyberg

"_Looking back on the memory of the dance we shared beneath the stars above, for a moment all the world was right, how could I have known you'd ever say goodbye … our lives are better left to chance I could have missed the pain, but I didn't have to miss the dance…"_ Lyric excerpt by Garth Brooks, _The Dance_

**Greene Memorial Hospital, Later that Day, July 4, 2006**

"Will the tests hurt?" Dean asked Dr. Finley as he looked into his brother's room and watched Bobby as he sat and talked to Sam keeping the young man company. When they had arrived with Sam the doctor had completed an initial exam and opted to admit Sam for more advanced testing.

"He'll be mildly sedated and shouldn't remember any of the discomfort," the doctor assured.

"But, you already said you're pretty sure he's got some kind of UTI again …"

"The urine sample I obtained through the catheter did show some bacteria but I feel the Cystoscopy procedure will show me if the UTI is causing some other issues that need treated along with the UTI."

"This Cysto thing it lets you go inside and look …"

"Yes, the diagram of the procedure I showed you, I will be able to get a look at his bladder and urethra and identify any issues that might be present."

"So, this is treatable?" Dean asked, daring to hope.

"Yes, but Dean it's also important to realize that some neurological diseases can cause problems in other areas, such as this and it could be a complication to Sam's PSP and if it is then he may need frequent catheterization if he continues to not be able to eliminate his urine on his own."

Dean sighed and rubbed a hand across his eyes. "Fine, do the exam," Dean relented. "I just don't want him scared or in pain," his voice firm.

"I'll have a mild anti-anxiety given to him to help take the edge off and I'll be ready to do the procedure soon and as I said he'll be given something to help with the discomfort."

"I'm going to go sit with him." The doctor nodded and walked toward the nurse's station to make arrangements for a procedure room to be set-up for Sam's exam.

**Two Hours Later**

"Well?" Dean asked anxiously in the hallway outside his brother's room. Bobby stood at Dean's shoulder and waited for the doctor to speak.

"The procedure went off without a hitch," Dr. Finley. "As you can see Sam is resting comfortably." Dean gave a thankful nod.

"So, did you see anything?"

"Well, the UTI he has this time around has caused some swelling in his urethra which has sort of pinched it off, so that is why he is having problems urinating. I've started him on some antibiotics to correct the UTI and some other meds to help reduce the swelling in his urethra."

"So, he's going to be okay? He'll get to come home?" Dean wanted the knot in his stomach to loosen a little.

"In a few days Dean," Dr. Finley responded. "I'd like to see him go home off of the catheter; although I will send you home with some extra catheters to keep you in stock should he have some issues."

"Issues? He couldn't go because his plumbing is swollen, so he'll be okay, right?"

"Dean, your brother is suffering from a neurological disease and it's a possibility that he could suffer from the urine retention again when it isn't due to an infection. I just want his care nurses to have the extra supplies should they be needed." Dean nodded tightly.

"So, how long do you have to keep him here? Not two weeks again, I hope."

"No, his UTI isn't as severe as the last time, but I'd like to see some progress in reducing the swelling before we remove the catheter and send him home. Maybe, two or three days, let's play it by ear, okay?"

"Yeah, alright," Dean sighed.

"So, doc, if this happens again he can stay home?" Bobby chimed in.

"The urine retention can be treated at the house with the catheter insertion but should he have another infection, of course I'd like to see him and whenever the retention happens, if it does," the doctor added for Dean's benefit. "I'd like to see him just to rule out any other problems but otherwise you can keep him at home." Bobby gave a thankful smile and nodded.

**Later that Day**

Dean stood down the hall by a window in order to get better reception for his cell phone. He dialed and waited. He half expected voice mail to pick-up but after the second ring a voice he knew well answered. "Hello? Dean?"

"Hey, Dad," Dean answered quickly.

"Are you boys okay? Sammy?" Dean heard the underlying fear when his father said his little brother's name.

"We're good," Dean replied. "Um, Sammy's in the hospital…"

"What? What the hell happened? What's wrong?" his father's questions fired off rapidly like a fully automatic 9mm gun.

"Relax Dad," Dean attempted to reign in his father. "He's got another UTI but this time it caused some swelling inside and he couldn't go, so they put in a catheter. The doc says he should be able to go home in a couple days."

"Do you need me there?" Dean could hear a little relief in his father's voice now but only a little.

"No. How are you and Cole doing? Get what or who you needed?" Dean hedged. There was a sigh at the other end and Dean had his answer and it wasn't what he was hoping for.

"This location didn't pan out but we have some more leads. Look, son, I'm going to go with Cole to one more lead location and if that doesn't pan out, he's going to keep looking and I'll come back, okay? Dean, I have every reason to believe at this point what we're looking for does exist but like I said they keep a low profile."

"What is it Dad? A creature? What? I need some answers, I deserve it." Dean couldn't keep the frustration out of his voice. He wanted to know what his father was going to bring around his brother and was it safe.

"It's a human Dean," John finally answered after a long moment. "Well, mostly, okay? Please, it's hard enough for me to accept what Cole has turned up … what I've heard from some people that say they've met one of these special people before. I'm not keeping you in the dark to hurt you son, but until I find what I'm looking for I'd rather not say more. I wouldn't put Sammy in danger, you know that," he comforted.

"Dad…"

"We'll get this done Dean," John assured. He had to sound sure to give his child hope. "We aren't losing him … you hear me?"

"Yeah," Dean forced out through his tight throat.

"Good, now you tell Sammy to hang tough and if you boys need anything, _anything_ you call me, okay?"

"Yeah, Dad," Dean replied.

A short while later Dean sat next to Bobby at Sam's bedside. "Is your daddy coming home?" Bobby asked quietly not wanting to wake Sam.

"I told him he didn't have to … he's still looking…" Bobby nodded because there was no need to make Dean say more in regard to the fact the possible saving grace for Sam had yet to be located. "Bobby, you've got deliveries to the salvage yard today you don't have to stay. Sammy's gonna sleep a good chunk of the day probably and you heard the doc he's coming home in a couple of days." Bobby gave Dean the look and he smiled. "I'm sure Bobby, if anything changes, I'll call," he assured.

"Okay, but if you boys need me…" he left the sentence unfinished.

"I know," Dean replied with a soft smile.

**Later that Day**

A nurse had already come and gone to change out Sam's various IV bags and gave him a mid-afternoon nutrition bolus. Dr. Finley wanted to keep Sam on the same feeding schedule he had at home and didn't want to disrupt his system anymore than necessary.

Sam shifted and opened his eyes. Dean was thankful that one PSP common problem hadn't happened to his brother. PSP patients often had trouble closing their eyes near the end stages and would have to utilize drops and eye ointment to help with dry eyes and would have to have their eyes taped shut at night. Sam could still open and close his eyes and Dean was thankful this one thing had avoided his sibling. "Hey kiddo," Dean kept his voice light. "You in any pain?"

Sam's eyes roamed in his big brother's general direction. He opened his mouth to attempt a word but saliva dribbled out and he swallowed deeply to try and quell the fluid. He coughed suddenly as the saliva went down the wrong way. He tried to sit up but couldn't and arched his head back trying to clear his airway. Dean stood up abruptly and grabbed Sam sitting him up and pushing him slightly forward. "Easy Sammy, easy," he soothed. "I need some help in here," he called out. Sam's nurse came in quickly when she heard Dean calling out for while she was at the nurse's station. Sam's face was red as he continued to cough. Dean was urged aside as the nurse grabbed a suctioning tube from the bedside and flipped a switch on. "He was drooling and just swallowed wrong," Dean commented absently as he watched Alice help his brother.

"Sam, I'm going to help with that, okay? I need to help clear some of the fluid this may feel uncomfortable. I'll be quick," she tried to calm her patient. Sam coughed and gagged as she suctioned his mouth and slightly down. He felt like he was having a strep test and gagged at the intrusion. She pulled back and he gave one final cough that turned him beet red and then it was over. His chestnut bangs were damp with sweat from the ordeal. "There you go," her voice cheery and calm. She adjusted a couple IV items and looked at Dean. "If you need me, let me know. I'll be back in a little later; Dr. Finley has added a couple additives to one of Sam's IV's."

"Thanks Alice," Dean was back at his brother's side as soon as she walked away. "It's okay Sammy it just went down the wrong pipe," he comforted. "It happens to the best of us. Remember that one time when I swallowed that beer wrong n that dive bar in Georgia? I sprayed the floor with PBR," he chuckled and knew Sam had found humor in the memory because Sam's mouth quirked on one side and Dean could see the attempted smile light his brother's eyes for an instant.

**Two Hours Later, Sam's Room**

Sam had dozed off an hour ago and the sleep didn't appear restful. Sam was moving slightly and didn't look comfortable as he slept. Dean watched him and couldn't help but notice his brother's cheeks seemed slightly flushed. He reached up and felt his forehead and his brow wrinkled in concern. He felt a little warm, not burning up but warm. He slipped out to the hallway and walked the short distance to the nurse's station. Alice was doing her change of shift notes with the nurse that was taking over her patient for the remainder of the night. "Hey Alice?"

"Yes?"

"Sam's looking uncomfortable and I think he's starting to get a fever." Alice stood up.

"I'll be back Lori, give me a sec'."

Alice walked into Sam's room and examined her patient. She took his temperature and noted it was 100 and his blood pressure was slightly elevated. Sam was moving in his sleep and she could see the discomfort. She pulled back the blanket and sheet and felt Sam's stomach and felt that it was slightly distended. She pushed ever so slightly and Sam grimaced in sleep. "I'll page the Dr. Finley at home to let him know what's happening but he turned over his patients for the night to Dr. Remmy, so I'll have him paged to come take a look at Sam."

"What is it?"

"I'll let the doctor take a look. His fever isn't high just slightly elevated at 100 his blood pressure a little up but it isn't dangerous … it's just letting us know that he isn't comfortable."

**A Short While Later**

"Okay, Sam," Dr. Jerry Remmy's voice was soft. Sam was awake now and was clearly in discomfort and not happy about all of the attention. The doctor listened to Sam's heart and lungs and then moved to the slightly distended abdomen. "He had a choking episode earlier?" he looked at Alice who was still present to inform the doctor about Sam before she left.

"His brother stated that he was drooling and swallowed wrong. I suctioned and helped him clear his airway. The coughing stopped and didn't occur again."

"Did you check for tube displacement?"

"I… I didn't think to since he hadn't pulled on it or vomited. The tape wasn't dislodged on his face. The tube appeared in place." The doctor nodded. It was true the tube placement on Sam's face didn't appear changed but that didn't mean there wasn't a possible problem with the tube.

"Sam this may hurt a little but I need to push on your stomach a little, okay?" The doctor pushed slightly and Sam moved under his touch. "Easy," he soothed. He tapped around Sam's stomach and stopped. "Okay, Sam just one more push, okay?" The doctor stepped back and wrote something in Sam's chart. "I think there may be a problem with Sam's NG tube. I think it may have become slightly displaced or perhaps there is a malfunction with it, so I'm going to pull it and we'll replace it with a new one. I think this will help."

Dean stepped forward, "That's an easy fix right?"

"It's fairly routine replacing items like this Dean. I'll pull the tube and we'll give him an hour or two to relax and then we'll insert a new NG tube." The physician looked at his patient. "Sam, we'll get you fixed up, okay? It will be a little uncomfortable but we'll give you something to help with the discomfort." Sam's eyes roamed in the general direction of the Dr. Remmy and his hand reached out, bobbing in the air and Dean knew instantly what his little brother wanted. Dean grabbed his brother's hand and held it firmly and rubbed a thumb comfortingly across Sam's knuckles and proceeded to trace calming circles on the top of his sibling's hand. "I'm here Sammy. I'll stay with you through it, okay? Just like last time. You've done this before kiddo," he urged. "You're okay," he soothed and Sam relaxed.

The doctor ordered some materials for the routine removal and Sam's evening nurse, Lori entered the room to help with the tube removal. "Okay, I'll make this as quick as possible. The medicine should help a little with the discomfort, alright? Here we go." Dean felt Sam squeeze his hand with more strength than he thought his little brother was capable of these days. He smiled in pride at his sibling.

"I'm here Sammy," Dean's voice soft and comforting. "Just relax and let the doc do his thing."

The removal was a relatively swift process, yet Sam arched against the pain and then proceeded to vomit violently as he felt the tube pass by the back of his throat and slide up into his nasal cavity as it exited out his nose. "Damnit," the doctor hissed. "He's vomiting!" The room suddenly erupted into a tense and hectic atmosphere and Dean felt himself yanked away from Sam as two more nurses and a young intern entered the room. Sam coughed wetly and gagged against the vomit.

"What's happening?" Dean called out anxiously.

Sam was suddenly rigid and all the color had drained from his face. He appeared almost grey. "Sonofabitch!" Dr. Remmy barked. "He's aspirating! What are his O2 SAT's?" Sam was struggling for air and getting very little. His gown had dropped down and Dean could see his brother's chest literally caving in and out to try and breathe. "Dammit! I asked what are his SAT's?"

"Sorry, he knocked off his pulse OX," Lori hurriedly answered and then read the new reading, "80," she answered urgently and just as the numbers dropped to 79 Dr. Remmy was already having respiratory paged STAT to Sam's room. "Jesus, get me an intubation tray, now! He's barely moving any air."

Dean watched in agony as Sam's eyes rolled back in his head and he began to seize. "He's hypoxic! Get 4mg of Ativan in this kid; we got to get this seizure under control." Dr. Remmy shouted. Within moments Sam's seizure had abated under the help of the medication pushed into his IV line. "I need that intubation tray," he barked as the tray was torn open and the materials handed to the doctor. He arched Sam's head back as he slid in the metal tongue blade preparing to intubate Sam. "And, where the Hell is respiratory!"

Dean stared at the scene in horror his mind still trying to catch up to how quickly everything had gone so bad, so fast, his mind focused on one thought, _please breathe Sammy, just take a breath …_

**To Be Continued**


	14. Nothing Gold Can Stay

Disclaimer: refer to chapter one

**NOTE TO READERS: **As always thanks for the reviews, PM's and emails! This chapter is around 11 pages long. Well, this story was going to have one more chapter left but it looks like it may be another chapter or two longer than I expected. Happy Reading, I hope!

**Side Note: **I have a SN story coming out with Ashton Press in a fanzine. I'll post the link on my profile page for anyone interested.

**So Long, Good-Bye**

**Chapter Fourteen: Nothing Gold Can Stay**

By Dawn Nyberg

"_Nature's first green is gold, her hardest hue to hold. Her early leaf's a flower; but only so an leaf subsides to leaf. So Eden sank to grief, so dawn goes down to day. Nothing gold can stay"_ Poem by Robert Frost, _Nothing Gold Can Stay_

**Two Hours Later, Greene Memorial Hospital, ICU**

Dean sat with his hand's folded in his lap, stretching and clenching his hands in fists. Bobby sat stoically beside the young hunter watching him out of the corner of his eye. His mind still reeling from the frantic phone call Dean had made after Sam's crisis. Now, the youngest Winchester lie behind two automatic doors since being transferred from his regular ward room to the ICU.

"Men?" Dr. Finley stepped into the medium sized ICU waiting room. The doctor had been paged and arrived to assess Sam.

"How's Sam?" Dean stood quickly.

"Let's have a seat," the doctor encouraged but doubted they'd take him up on the offer.

"No, just tell me," Dean's eyes were intense.

"Well, let's start off with the minor issues," the doctor began. "The NG tube had a faulty segment and was slightly kinked, so that is why he was having the discomfort and the slightly distended abdomen. The tube has been replaced and is working fine. Now, the removal as you know did have a complication … Sam vomited and aspirated into his lungs. The aspiration wasn't small and his lungs became quickly compromised and his oxygen levels dropped swiftly causing the seizure from a too low oxygen level in his blood."

"Doc," Dean's eyes were pleading. He wanted the details but he needed to know one thing and Dr. Finley knew the words.

"He's alive Dean," he said softly.

"But?"

"Dean, we've suctioned what we were able to but stomach fluid and although he hadn't had a feeding within an hour of his tube removal there was some feeding fluids in his stomach and he deeply inhaled during the vomiting and with his swallowing issues .... He isn't breathing on his own at all right now. And, respiratory has increased his vent settings to help keep up his oxygen levels but they are having problems."

"Problems? Do whatever you have to," Dean stepped forward. The doctor shook his head slightly.

"We will Dean I assure you but Sam's condition is very critical. He has a fever and I'm certain a lung infection is already setting in with his weakened immune system. I've started him on an aggressive IV antibiotic treatment, but…"

"But, nothing, Sam will get through this, he will," Dean's voice was forceful.

"Dean," the doctor began softly. "We've talked about this and you know that aspiration is the leading cause of …"

"Don't," Dean's voice held venom in it. He knew the facts, he'd read the literature. The most common cause of death among PSP patients was aspiration pneumonia with various other infections as secondary causes. The doctor sighed.

"Doc," Bobby began. "Can we see him?"

"Sure, he's unconscious but until he regains consciousness from the seizure episode we won't be able to fully assess his neurological function. So, talk to him try to bring him around. Maybe, if he's awake he'll fight more," the doctor offered and Dean looked at the man and offered a soft smile of thanks.

Dean sat at his brother's side and looked over at Bobby. "I should call my Dad," Dean said absently as his eyes went back to Sam.

**One Hour Later**

"I can do it," Bobby answered easily. "You stay with Sam." Bobby started to stand and a slight stirring from Sam stopped him. Dean stood quickly and was standing over Sam. His hand gently pushed back his little brother's bangs in a soft, soothing motion.

"Sammy? You in there kiddo?" he kept his voice soft. Sam puckered his eyebrows slightly as he shifted toward waking. Dean and Bobby both waited, the only noise in the room was the slight rustle of the sheet and the constant click and whoosh of the ventilator. Sam's eyes opened slowly and his eyes were hazy and distant. "Sam?" Dean made his voice a little more sure, a little more forceful and it worked, Sam focused his roaming eyes for a moment. "Hey there Sammy, I'm here. Bobby's here," he soothed. "You're going to be okay, alright?"

Sam felt the intrusion in his throat and how his lungs felt forced to fill and release, he wanted to fight it, but he was so tired and his body weak that his efforts to buck the vent were fruitless. "Easy, Sammy," Dean urged as he detected his brother's unease with the breathing tube. "It's helping you right now," he continued. "Don't try and fight it, just let it help. The doc will take it out as soon as he can, okay? You got sick when your feeding tube came out and you got some stuff in your lungs. They're giving you some medicine and you're going to be okay. I'm here and I'm not going anywhere."

Dean looked at Bobby for a moment and the older man could see that Dean was trying hard to believe that his brother would get through this but him letting Sam think anything else wasn't an option. Sam had to believe this wasn't it that there was another side to come through with this setback.

"I'll call your Daddy," Bobby spoke up. He reached down and cupped Sam's right cheek avoiding the breathing tube. "Listen to your brother Sam," Bobby coaxed. "I'll be back in a bit. Just rest," he urged with a gentle tone. Dean offered a warm and thankful smile toward the older hunter.

**Outside the Hospital**

Bobby needed some air and knew he had to call John. It was one thing he could spare Dean from doing. He knew the boy was hanging on the razor's edge, as it was, so he wanted to take on what he could for the young man. He pulled out his cell phone and selected John's name. The phone rang and Bobby soon heard his friend's voice.

"Bobby?" John had seen the caller ID. "Are the boys okay?"

Bobby cleared his voice. "John," Bobby began and he could hear his friend's breath catch in his throat. "Sam had a complication when his feeding tube was removed…"

"Dean said Sammy would be home in a couple days or so, what the hell happened?"

"He vomited when they pulled it," he paused. "He aspirated again." The line was silent for a moment.

"How bad?"

"He had a seizure from low oxygen when it happened," Bobby decided John wanted and needed nothing held back. "He's on a vent again. He wasn't breathing on his own earlier, but he's awake now. The doctor says it's a bad aspiration and Sam's already running a fever and they are treating him for a lung infection…"

"Pneumonia?" John's voice was tight.

"Yeah, that's what I was hearing without the doc out right saying it."

"Bobby?" The older hunter heard the unvoiced question John was asking, _is Sammy getting through this … do I need to come home._

"John," Bobby started. "I'll give him a couple days see how it's going and if he isn't doing any better, maybe…"

"I'm coming back," John blurted. "Cole can follow up on the search, he'll call …"

"You have another location?"

"Yes," John replied.

"Follow it up John. I'll call if Sam gets worse, okay?" There was another long silence on the phone.

"Fine, but if this one doesn't pan out I'm coming back and Cole can take care of this. The next lead is a couple states away and it'll put me a good two days drive from you, so…"

"I'll call the minute I think you need to come," Bobby assured. "If you have to fly … I'll get you at the airport, alright?"

"Yeah, tell the boys…" he paused. Bobby smirked despite the dire situation. He understood what John wanted to say that he loved them.

"I'll tell them, just do what you need to for Sam.," he paused. "We're getting close to the wire."

"I know," John agreed. Bobby could hear the stress in his friend's voice. "How's Dean holding up?"

"You already know the answer to that one Johnny."

"Yeah, I do. Take care of them," he asked. "We'll get this done," John assured. He had to believe they would and Bobby was more than willing to believe John, too. He couldn't imagine losing Sam anymore than John or Dean.

**Meanwhile, Sam's Room**

"You gotta fight this Sammy," Dean stroked his brother's forehead. "You beat this and we can go home and Dad will fix this when he gets back," Dean whispered near Sam's ear. Sam was still partially awake but his roaming eyes were distant and Dean knew his brother was only partially there but he knew Sam could hear him because his fingers curled around those of Dean's left hand. "I'm right here Sammy." He could feel the fever burning inside his brother. He pulled his hand away and brought over a cool cloth to run across his brother's forehead.

A technician came into the room. "Hi, I'm Charlie from respiratory. I'm just here to check his vent settings and do some things. You don't have to leave," he replied. Dean nodded. "Hi Sam, I'm Charlie. I'm just going to check some things with your ventilator, okay?" The tech proceeded to check settings and write numbers down. "Sam, I'm going to check your tube near your mouth, all right? I need to adjust the tube holder." The tech was quick, gentle and efficient and Dean appreciated that. "Okay, that's it Sam. I'll be back later before my shift changes, okay?"

"Thanks," he offered quietly as the man turned to leave.

"No problem, you're more than welcome."

Dean smoothed the cool cloth across Sam's forehead again and allowed it to rest there. His hot, dry skin sucking up the coolness and quickly turning the cloth warm. He felt Sam lightly squeeze his fingers once again. "I'm here kiddo," he soothed. Dean watched Sam's features relax and his eyes slide closed.

**Three Days Later, ICU**

Dean scrubbed a hand over his tired eyes. He stretched in the lounge chair he had next to Sam's bed. He wished he had said something more to his brother three days ago, if he'd known that when Sam closed his eyes that he wouldn't open them again, he'd had said more than _I'm here kiddo_. Sam had slipped into unconsciousness three days ago and his body was weakening against the fever that wouldn't let him go. Dean tried denial but he knew the signs of what was happening … Sam was losing this fight. His body too weak to fight back from this one. He was taking breath's on his own but not enough to survive off the vent for very long. He hoped that would change. The med's were working but not fast enough and the truth was Sam's lungs might be too damaged to bounce back from this one.

There were a slew of IV bags around Sam. His glucose levels were off the last day or so and Dr. Finley was having that addressed. His blood pressure was having trouble staying up so IV meds had been ordered to help combat that issue but they were already on their second different medication, as the first stopped being effective and the dosage was maxed out, so they switched and this one seemed to be working for now. "Sammy? I need you to listen to me, okay? I know you're tired and I know you're hurting, " his voice caught with emotion and he swallowed it back down hitting his gut as if he'd just choked down a cold stone. "You can call me a selfish bastard if you want but I need you to fight a little longer. I need you to open your eyes." He stroked his brother's right arm gently. "I need you to hold on, please…" his voice caught once again but he couldn't hold back the emotion any longer. He bowed his head and silently cried.

Bobby stood in the hospital atrium and tried John once again. He had tried calling more times than he could count over the last couple days when Sam took a turn for the worse but he wasn't picking up and hadn't returned any of the voicemail messages he'd left. He was half worried and half pissed. He hoped the lack of response meant John was out of cell range, maybe somewhere where there were no nearby cell towers for service, maybe John had found what Sam needed, what they all needed. "Dammit, John," Bobby hissed under his breath, snapping the phone closed without leaving a message. After all, he'd left more than ten and called at least fifty times and still nothing.

Bobby patted his jacket pocket to make sure the letter he went home to get was still safe inside, it was. He had locked up this letter months ago when he'd helped Sam with it. His mind recalled the day Sam had asked him to write a letter for him, to write what he said. Dean had gone out that afternoon to pick some things up for Sam and the young man had used the opportunity to dictate a letter because he couldn't write it himself. Sam had still be able to communicate verbally then and this letter was something he pleaded with Bobby to help him with and to keep it from Dean until Bobby knew the time was right to give it to the older brother. He walked inside the hospital with a heavy heart.

"How's he doin?" Bobby asked from the room threshold. Dean looked up.

"His fever is down a couple degrees," Dean's voice was hopeful. "Respiratory said they were able to lower the vent settings a little."

"Really?" Bobby stepped forward daring to hope. He glanced at the vent and could see the numbers were only slightly changed. "Is he taking any more breaths on his own?"

"A couple here and there," Dean offered honestly. "But, the doc still says he wouldn't last a long time off of the vent, maybe a few hours or less." Bobby heard the sadness in that statement. He dropped a hand on Dean's shoulder. "My Dad picking up yet?"

"No, but I'll keep trying."

"If he isn't picking up, maybe he's found what Sammy's needs and just doesn't have the cell on him … could be out of range," he threw out as he stroked his little brother's arm.

"Yeah," Bobby answered lightly. "Dean?"

"Yeah," he turned and looked at the older hunter.

"I have something for you," he pulled the letter out of his jacket pocket. "I feel like I should give it to you now." Dean looked confused.

"A letter? Who's it from?"

"Sam," Bobby answered softly. Dean's eyes went wide. "He had me help him a few months back when he could still communicate pretty well but couldn't write. He made me promise not to tell you about it or give it to you until I thought I should. He extended his hand with the letter.

Dean stared at it, as if it were an instrument of torture and as if reflex a drew away from it. "No," his voice ground out low. "I don't want to read it. This ain't some death bed crap and I'm not doing it." Dean stood up abruptly and walked out of the room. Bobby followed.

"Stop," he reached out a hand as he caught up with Dean as the young man hit the automatic door button at the ICU exit door. Dean kept moving forward and Bobby jogged a few steps and grabbed Dean by a shoulder. "Dammit boy," he grumbled and spun Dean around and what he saw took his breath away. Dean was crying. Bobby simply cupped a hand firmly around the back of Dean's neck and pulled him forward roughly and held him. "I got ya boy. I got ya," he assured roughly. Dean wrapped his arms around the older man and buried his face. "I got ya," Bobby said once again as he patted Dean's back.

"But nobody has Sammy," Dean choked out. "This shit he's been going through for month's now … I can't help him, I can't … I can't say good-bye," Dean choked. Bobby fisted Dean's shirt in his hand and held him firmly.

"No one is asking you to Dean," Bobby assured. "This letter is your brother talking to you … it's a gift Dean."

"He's not going to beat this Bobby," Dean stepped back and wiped at his face. "Dad should be here and not chasing some wild goose chase. Sammy'd want him here. That letter is some damn swan song and I can't…"

"Now, listen here, you're not giving up on your brother Dean … it's never too late until it is too late. He's down that hallway and he's still fighting dammit … don't you give up on him. He'd never give up on you and you damn well know it," Bobby's eyes blazed.

"I'm not giving up on Sammy … I can't do that, not now not ever, but…"

"No but's Dean. Look I'm not living in a pipe dream here kiddo and I know this story is edging toward it's final chapter but the last page hasn't been written, not yet, okay? You hearin' me?"

Dean offered a tight nod. His hand extended and Bobby knew he was ready for Sam's words. Bobby handed him the sealed letter. He looked at the envelope and frowned, he recognized the handwriting albeit messy, it was Sam's. "He wanted to write your name on it and he signed it, too." Bobby answered without being asked the question. "Go on, take a walk," he urged. "I'll stay with Sam. I have your cell number if I need you back up here sooner, okay?" Dean nodded and walked away without another word.

He sat in a quiet corner of the empty first floor chapel. The wood pew creaked as he sat down. He took a breath and opened the envelope:

_Dean,_

_If you're reading this then it must mean things haven't gone the way either of us wanted. If Bobby is giving you this then I must be losing this fight. Look, I know trying to be supportive of my Living will and Advanced Directives aren't easy for you since they go against every big brother instinct you have where I'm concerned. This isn't your fault you know? You didn't fail me, you never have. You've been there for me my entire life and you've never let me down and as selfish as this sounds … I'm counting on that now._

_I don't want my last days to be in some damn sterile hospital room. Dean, if I can't communicate for myself and the directive hasn't been enforced yet then, please do it for me. Dr. Finley has always been a straight shooter, he'll tell you if there isn't a chance for me to get well enough to go back home. I know it's asking a lot, I do, but I need you to accept when enough is enough. I'm losing so much with this disease, please don't take my final wish away from me. I'm not asking you to stop being my big brother, you'll always be that no matter what, but I am asking you to help me let go. _

_You know what I want, what I need … I wish I could thank you for all the years that you've been there for me while growing up but time seems to have slipped away and you always say, 'no chick-flick moments'._

_This isn't a good-bye Dean … there is never truly a good-bye between brothers. _

_Sam_

Dean's hands shook and the paper wobbled in his fingers. Hot tears cascaded large and unchecked down his face. He understood in this very moment what it felt like when your soul fractured.

**Two Days Later, ICU**

Sam had regained consciousness but was very weak. The IV's were helping to fight the infection and his fever was all but gone, however, his body had been severely weakened and his lungs continued to have issues from the latest aspiration. Dean sat at Sam's side, the letter weighing down like a stone in his pocket. "Sammy?" Dean's voice was tentative and Sam's eyes opened fractionally at his brother's voice. "Kiddo, I need you to wake up for a little bit, okay. We gotta talk," Dean squeezed his brother's hand and Sam returned the squeeze. Dean smiled as his little brother's fingers curled around his own.

"Sammy, I read your letter," his voice was quiet and he fought to keep it from wavering.. Sam's eyes roamed and settled on a Dean for a few precious seconds. The breathing tube was still aiding Sam but he had given into machines timing and only bucked it once in a while.

"Sam," Dean stroked his brother's forehead with his free hand. "I'll do … I'll…" his voice dropped off and he felt his brother lightly squeeze his hand. He looked up and smiled. His little brother was giving him support, even in his weakened state he was being strong for him. "I''ll do what you asked, alright?" He forced out as his jaw tightened involuntarily at the words. They went against every in him where Sam was concerned. "But, I want you home Sam, no hospice. You belong home. Please…"

Sam turned his back toward his brother and his fingers wrapped harder around his. He wasn't sure if that was his sibling protesting or agreeing. "Sammy, squeeze once, if it's okay or twice if you want the hospice." There was a long moment where Sam did nothing but Dean could clearly see the battle waging behind those warm eyes and then it happened … a single squeeze, firm and as strong as it was able to be. "Really?" Dean dared to hope.

Another squeeze to affirm Dean's hope. Dean stood up and bent over his brother. He pushed back Sam's chestnut bangs and gently kissed his brother's forehead. He rested his own forehead on his little brother's for a moment, "thank you Sammy," his voice rough with emotion. Sam moved a hand up and touched the tubing leading to his breathing tube. "I'll talk to the doc, okay? You've been doing better, let's play it by ear," Dean said hopefully. "I don't hear that fat lady singing yet, so don't go walking into any white light little brother. We're not done fighting this yet, not yet…" Sam's fingers once again curled around Dean's for a moment and his eyes slowly blinked. "Hey, kiddo, close your eyes and get some rest. I'm here," he assured.

**Two Hours Later**

"Doc, I wanted to talk to you about Sam," Dean sat across from Dr. Finley in his office. "I need you to tell me where we're at … you've always been straight, so…"

"Dean, Sam is a fighter, I'll give him that but this isn't a fight he's going to win. This PSP case has been rare and aggressive from the start. This latest aspiration has been too much for him …"

"But, he's taking more breath's on his own. His fever is basically gone. The med's are working…"

"Yes, the med's are working Dean but to what end? His blood pressure is still requiring IV intervention to keep it up and stable and we will most likely be changing medications again soon. His lungs are severely compromised. He could come off the vent but he'll only last a few hours. Dean, you asked me to be straight with you and I will be," the doctor looked at Dean and could see the anguish in the young man's eyes. "It's time to honor Sam's directive." Dean wanted to bolt but he had to do this, he had to for Sam.

"Sam," Dean's started and stopped. He took a deep breath and continued. "He's willing to go home rather than a hospice. I talked with Valerie once and she said that home hospice care could happen for Sam…"

"Yes, but Dean, I can't discharge him without taking him off the vent and he'd pass away within hours…"

Dean's mind had been thinking hard on a way to keep Sam with him longer and keep him comfortable. "Isn't there something he can get set-up back at that house to help him breathe or something that isn't a vent. I'll ask him but I'm sure he'll agree to something that isn't a vent, something that is just helping but not doing all of the work." The doctor rubbed a hand across his eyes.

"Okay," he started. "There is something I could have delivered and set-up at the house. We use these machines in the ICU for patients that have been extubated but are in danger of respiratory failure and intubating again isn't an option. It's a BiPap machine, it's on a larger scale than those used by people with sleep apnea but it can help deliver oxygen to Sam and it forces positive air into him when he breaths. It will help him take deeper and more frequent breath's. But, he's still requiring blood pressure medications Dean and without them his pressure would bottom out and would likely trigger a cardiac arrest."

Dean felt his body trembling but he tried to hide it from the doctor. "Can't you send him home with whatever IV's he needs? Valerie and Margaret can handle them. They are certified in advanced care, right?"

"Yes, but…"

"He wants to be home doc. He had our uncle help him write a letter a few months ago when he could still talk and he doesn't want to … he doesn't want to …" Dean couldn't say the words. He turned pleading eyes toward the doctor.

"He doesn't want to die in a hospital," Dr. Finley offered quietly. Dean nodded tightly. His eyes burning and stinging but he refused to let the tears fall. "Fine, I'll make the needed arrangements and I can probably have him home in a day or so. But, Dean, you need to accept that he's not going to get better. I know this is hard, but he's being released to home hospice care and based on his directive, he'd be home under what we call 'comfort care'."

"Comfort care?"

"We keep him comfortable with IV fluids, meds for pain and anxiety, but comfort care means that we won't keep adjusting his blood pressure meds or his BiPap settings to compensate for drops. Here in the ICU we have been adjusting his blood pressure medication frequently to compensate for drops but with comfort care the settings he goes home on will remain the same. The BiPap machine will be on the setting that keeps him from struggling but once that setting is set it will not be adjusted. This is about helping Sam to let go, to pass away peacefully. This isn't about him getting better. Also, you need to know that should his pressures bottom out or he stop breathing even with the BiPap mask in place there won't be any heroic measures to resuscitate him. He'll be allowed to die."

Dean looked away for a moment. "I want him home." His voice was tight.

"I'll start making the arrangements and we'll wean him off the vent and with his approval we'll start trying the BiPap mask, but this is his call Dean. You should know that even if he agrees to the mask, if he changes his mind at home and wants it taken off it will be removed and like the vent removal he'll have a few hours at most."

"I get it," Dean couldn't keep the bitter sound out of his voice. He hated this and he hated the fact his father was still not picking up. Sam needed him here and so did he.

"I'll make the arrangements for the care to become advanced home hospice care. I'd like everything delivered and set-up before Sam is returned home in order to make his transition as stress free as possible. He'll be taken home via an ambulance." Dean nodded. "Once plans are arranged Dean, I'll need to talk to you about some other issues, too, alright, but for now go talk to Sam and I'll be in to get his approval for the vent removal and to start him on the BiPap."

Dean walked back to the ICU. His heart aching, his soul splintering …

**To Be Continued**


	15. Heard the Shuffle of the Angel's Feet

Disclaimer: refer to chapter one

**NOTE TO READERS: **As always thanks for the reviews, emails and PM's, they are all appreciated. Okay, this chapter was giving me issues because I had come up with this story idea sometime during Season 3 and then Season 4 happened and I thought crap now what? I had an idea on what and/or who would be John's lead and then we had season 4 and I hesitated, but then I decided I had this idea way before Season 4 was even a spark in Kripke's eye, although he hasn't used what I have in my story, but nevertheless ... This chapter is around 16 pages long and I expect to have 1 or 2 more chapters before it's complete. Thanks for everything. Happy Reading, I hope!

**Side Note:** The title of this chapter is a line taken from the Johnny Cash song, "God is Gonna Cut You Down."

**So Long, Good-bye**

**Chapter Fifteen: Heard the Shuffle of the Angel's Feet**

By Dawn Nyberg

"…_Who is gonna save you when I'm gone? Who'll watch over you? Who will give you strength when you're not strong? Who'll watch over you when I've gone away? … You long to hear my voice, but I'm long gone." _Lyric excerpt by Alter Bridge,_ Watch Over You_

**Two Days Later, Bobby's House**

Dean leaned back into a leather overstuffed chair in the corner near Sam's bed. He was still getting used to the noise the BiPap machine made and they had moved it further away from the bed, as to try and not disturb Sam anymore than needed. He seemed to be tolerating the mask but Dean knew it had to be uncomfortable to some degree. It was a large mask that covered his brother's mouth and nose and was strapped around his head holding it firmly in place creating a seal. The positive air was forced in with each of Sam's breaths. The sound this machine lacked the click and whoosh of a vent but was louder and an almost constant whooshing hum, it was hard to describe but if he focused on it too long it overwhelmed him. Sam was subjecting himself to this for his family's sake, for him and Dean knew it.

Sam had been discharged from the hospital without a catheter and that was one small bit of thanks Dean had. Sam's infection had cleared up and the swelling causing the retention had abated, so he was now back in his adult diapers. Valerie and Margaret were keeping tight shifts with Sam since his care level had increased. There were two IV poles that stood on one side of Sam's bed and were angled slightly off to the side to allow family to be able to sit at either side of Sam's bed to visit with him, to be with him. Before Sam had been discharged they had moved onto what Dr. Finley had said was the last blood pressure IV meds they would switch Sam to. They had adjusted the settings and his blood pressure was maintaining. There was a monitor that was behind Sam's bed that Dr. Finley had wanted for Sam, as well. Dean could easily look at it and know Sam's oxygen levels, blood pressure, heart rate and even his body temperature.

Sam stirred in his sleep; he'd been sleeping more, but would wake for Dean or Bobby when they asked him to. Dean was thankful for the times Sam woke on his own and wanted the company. "I'm here Sammy, shh…" Dean soothed softly as he stood up from his chair and walked over to his brother and placed his hand on the crown of Sam's head. It was harder to stroke his bangs since the bands around his head for the mask trapped his unruly chestnut hair. His hair stuck out in cowlicks around the bands. Dean leaned in and kissed the spot his hand had been. Sam settled into slumber once again without ever opening his eyes.

Valerie walked into the room quietly, "I'm sorry Dean, I have to check his fluid levels and change out some bags," she had been stepping out of the room when Dean or their uncle Bobby came to be with Sam. She knew this was likely their last days with Sam and she gave them their privacy as long as they or Sam weren't requesting her or Sam's care didn't need attended to. "I should check to see if he's wet, too."

"I'll be in the kitchen, you'll…"

"Come get you as soon as I'm done," she assured with a gentle smile. "Your uncle is making some soup and a grilled cheese for you," she commented as she began checking bags and hanging new ones that needed replaced.

"I'm not hungry," Dean replied as he reached out and stroked his brother's arm gently.

"Dean, you need to eat," she urged. "He'd want you taking care of yourself. I didn't get to know the Sam you grew up with but I have been introduced to his stubborn nature before the PSP became so advanced, even now it slips out for short spurts," she smiled and looked at her patient. "He'd be telling you the same thing, right?" Dean looked down at his brother and smiled, but it was a bittersweet smile and he looked up.

"Yeah. Yeah, he would." Dean stayed until the bags were checked and switched and then he stepped out, so Valerie could take care of Sam's other needs and gave his little brother some privacy. She closed the door and Dean walked to the kitchen.

He walked in a saw Bobby closing his cell phone. "You get a hold of him?" His voice was hopeful. Bobby shook his head in frustration and now a little apprehension. John wouldn't be this out of touch especially with Sam on the brink. He hoped John was out of range and had found what Sam needed, but part of him, the hunter side, was hoping John hadn't bitten off more than he could chew and was hurt or worse dead.

"No, and I tried Cole's number, too. There's still no answer from either of them." Dean sat down heavily in the chair. Too tired and worried about Sam to muster up further conversation where his dad or this so called lead was concerned.

**Early the Next Morning**

Valerie pushed a little nutrition feed into Sam's NG tube at a very slow rate and watched the monitors. "Something wrong?" Dean's voice came from behind. It was a little after 6:30 in the morning and Dean was wide awake. They had been using a mask that allowed for a small NG tube to work that didn't interfere with the seal of the mask to adequately help to ventilate Sam.

"His pressure gets a little dodgy when I push the feed too fast, so I'm doing it slowly, so that his pressure can stabilize a little. I think Dr. Finley will have me pull the NG tube today Dean," her voice tentative. "We'll keep him hydrated with fluids and some dextrose to keep his glucose levels stable. He'll still have his supplement IV fluids to keep his other levels okay, but the feedings will stop. He'll be comfortable," she assured.

"Won't he be hungry?" Dean asked absently as he stepped over to his brother's side and stroked some skin peeking out from between the two bands that were on each side of his cheek.

"Sam's on a pain medication that as you've noticed has a sedative quality to it. We're keeping it at the minimum level, so that he's not completely out and can wake on his own or if asked to respond. Dr. Finley also prescribed a low dose Ativan injection for him that I give to him to help with any anxiety he may be feeling from the mask or in general. Everything is being done to keep Sam physically and emotionally comfortable Dean. He won't feel the hunger," she put a comforting hand on his arm. Dean looked into her eyes. "He's not suffering sweetie," her tone soft. Dean's jaw tightened and he looked away fighting the hot sting in his eyes.

"Can I be with him alone for a while?"

"Sure, he's all up to date on his fluids and meds, if you need anything let me know. I'll call Dr. Finley's pager to ask about the NG tube." Dean nodded and Valerie excused herself. Dean watched her go and slightly closed the double wooden doors to the library but left them cracked. He walked around the bed and pulled on the blinds a little, he wanted some of the sunrise to come in, Sam liked sunrises, he always had, even as a kid. Dean looked at the monitors. Sam's heart rate was 70 and holding, his O2 sat' were at 93, not great but they seemed to be holding for now with the mask's help, his blood pressure was holding around 90/68 with little variations but the IV medication was still working.

Dean lowered the bed rail and slid in beside his brother. He was careful with the tubing attached to the mask from the other side of the bed and the wires and tubes attaching Sam to his monitor and his IV's. Sam stirred and opened his eyes. Dean cocked his head and looked at his brother. "Hey kiddo, good morning," his voice was soft. Sam lifted a weak hand and turned his hand palm up and offered a small wave upward toward his brother. Dean smiled. "The sun's coming up over there Sammy it's just about over the cars in the yard, you'll see it soon." Dean watched Sam's eyes track over with some control this morning toward the window. His eyes weren't roaming as much and Dean quirked an eyebrow and angled himself to see his brother's face. "Sammy?" his voice quiet. His little brother's eyes shifted toward him and although the gaze drifted a couple times he was able to look at him for a long moment. Valerie had said she had see in the past that near the end some PSP patients actually gained a little eye movement control back, she had always equated it to a small gift but Dean knew the truth it was probably just that part of the brain just finally giving up the fight. "Hey there, little brother," he smiled and he could see the corners of Sam's mouth tweak up just a tad in response under the large mask. Sam turned his head back toward the window as a soft ray of light streaked across his blanket. The sunrise was coming and he wanted to see it. Dean watched with him.

**Later that Afternoon**

The NG tube had been pulled. Dr. Finley came to personally do it wanting to insure that Sam didn't have any complications that Valerie couldn't handle. The tube removal went off without any incident. Sam's oxygen levels had dropped a little but were holding at 91 and his blood pressure had dropped a little, as well, but just slightly 89/66. Dean felt a loss of control and wanted desperately to beg the doctor or Valerie to adjust the meds _just a little_ to help Sam's vitals rebound but he knew comfort care was what Sam wanted and what he'd agreed to when Sam was released to home hospice care. But, he also knew any adjustment would just prolong the inevitable for Sam. He looked at the monitor wanting to know his brother's heart rate, and frowned at the very slight drop to 69. Just a point but it still hit Dean hard. Sam had only been home for three days and he wasn't ready to let his brother go and then his jaw tightened and he accepted the hard truth he was _never going to be ready, yet it was going to happen anyway_.

Sam stirred and Dean leaned forward. He had grabbed a smaller chair that allowed him to sit right up by the bed to be able to touch Sam. "Sammy, I'm here," Dean touched Sam's arm. Sam opened his eyes and allowed them to drift slowly toward his brother. He weakly mouthed a single word, a question really, _Dad_? "Sammy, he's off looking for a way to help you. We've tried calling but he's not answering. He'll be here okay, he will," Dean wasn't sure what else to say. He knew Sam wanted to see their father before he let go and Dean hated his father right now. He wanted to give his little brother this one thing and couldn't. He knew that Sam and their dad had unresolved issues. "He'll be back Sammy."

Dean sat that day and visited with his brother. He talked to him about stories from their childhood. He talked to him about hunts he'd been on while Sam was at _Stanford_ and had opened up about how he'd missed his little brother and had driven to _Stanford _on his own once or twice, _maybe_ … just to check on said little brother. Sam did smile faintly at that and despite the situation Dean even saw a slight hint of dimples in each cheek.

**Meanwhile, Two Miles off Highway 2 Just outside Cut Bank, Montana**

"Look, I haven't been able to get reception for days and I need to talk to my boys," John bellowed.

"John," Cole said.

"No! He can save my boy and he's worried about heaven and hell locating him," John turned angry eyes toward the man who stood in front of him. "You hide out here in the middle of nowhere in a damn cabin … if anything is worth dying for it's this," John stepped forward.

The man shook his head, "for you maybe it is and that is understandable, he is your child. But, he isn't mine. I have found a place that I have been able to live without being hunted. I have explained to you that I am …"

"I know dammit! Both Heaven and Hell consider you an abomination, you and your whole damn race. But, you can save my son."

"I know your desperation … I can read your thoughts, sense your emotional state but …"

"Please," John's voice broke. He and Cole had found this man a few days ago and he'd hated going out of cell reception range but this was for Sam. "He's my child, he's only twenty-three years old, he's still a kid. You already said you've survived longer than most of your kind. You've hated what you are your entire life then do something to make your struggle worth something … save a human life."

"I am human," the man shouted. John lifted his hands in a placating manner.

"Then honor your human half and save my child. James, please…" John used the younger man's name all the while not allowing himself to think Sam might already be gone.

"You have no idea what it has been like," James started. "When we turn eighteen we come of age and then we're on the radar. Hunted by Heaven and reviled by Hell. Imagine having no place that will accept you. I hear the thoughts of everyone, I understand every language of the world … hell, I even understand ancient languages that have been dead for millennia's. I can heal anything even …" he broke off and turned away.

"What?" John stepped forward. "You can even what?" James huffed.

"Nothing …" James stopped and rubbed a hand over his face. He looked around at his quiet life, his safe life and tried to force out John Winchester's thoughts, his feeling, but the love he felt for his children was overwhelming to the man. He realized then that his quiet, safe life was an illusion and John was right, it was time to step up and use his inborn abilities and to no longer see them as a curse. "I'll help," he said suddenly. "But, I need at least a day to prepare some wards to mask me from …" he dropped off. "I won't be any good to you or your son dead."

"Mask you from what?" John asked. Cole stood silently. He had been much more willing to accept what James truly was than John.

"Archangels, they are charged with the task of destroying us … the Nephilim are abhorred by Heaven because of what we are … half-human, half-angel. I guess Heaven doesn't like to know it's got some dirty laundry out here in the world. But, the truth is that not all of the Nephilim were conceived from a Fallen Angel and they choose to ignore that fact that some of their own that are not Fallen have lain with a human and conceived a child, a half-breed … it doesn't matter, from the moment we turn eighteen they can sense us and unless we run, unless we learn how to hide. Most of us die young but I've struggled to get to thirty-eight, but I can see now that this isn't a life … it's a prison. Heaven may not have killed me yet but they got me locked up in my own personal prison just the same …" John felt overwhelmed by the young man's words. He was still having trouble believing in his lineage and the thought went through his head that moment. James chuckled quietly and shook his head in amusement and bewilderment. "You have no trouble believing in Hell and demons but you question Heaven and angels?"

"Yeah, well …" James raised his hand interrupting John.

"You've seen demons and know enough of Hell to believe in it, well I'm real and there is no denying what half of me is," James commented. "Lucky for you I don't need you to believe in me … so I should get started with preparing. I can be ready by late tomorrow. If I don't make these wards they'll be on me, on us for that matter like a hyena on a fresh kill." James started to walk to his kitchen.

"On us?" Cole spoke now. James stopped and turned.

"Archangels are absolute and if turning you to ash along with me is what it takes to have me dead then they'll destroy you, too." John and Cole both sobered. John rubbed the pocket to his jacket and felt his phone there. He wanted to call his boys and see how Sam was doing with the aspiration pneumonia and for the hundredth time in days he cursed the lack of cell reception in this remote mountain area and he was still over a two days drive from Bobby's.

**Meanwhile, Back at Bobby's**

Dean brought in a portable CD player and plugged it in not far from Sam's bed. "I thought you'd like to hear some music Sammy," Dean stood at the end of his brother's bed. "So, what do ya say Sammy?" Dean watched his brother turn his head from looking out the window and he could see how weak Sam was and the paleness of his skin. But, despite it all he could still see the light in his brother's eyes and he had to fight the tightness in his throat that was suddenly there. Sam's eyes roamed slightly but still settled on Dean for a long moment and he offered a slight nod. Dean smiled. "Good, so what do you have buried in this duffel, huh? Probably tons of that emo crap you like to listen to," he glanced back at Sam with a glint in his eye and smiled at his little brother. Sam offered the smallest of smiles back. Dean dug deep into the mystery CD collection of his brother's, "Damn kiddo, how many do you have stuffed in here, he pulled out one and started at it, "Who the hell is Clannad?" He started to put it back and Sam grunted.

Dean looked at Sam then, "What you want this one?" Sam nodded slightly. He raised his hands and showed his big brother nine fingers, he paused and then showed seven fingers," Dean raised his eye brows trying to decipher his sibling's sign language and then he got it, "you want me to start on track 9 and then play 7 for you?" Sam did smile to the best of his ability then and Dean smiled back.

Dean listened to the first track with his brother and he didn't understand a single word of it and of course leave it to Bobby to have walked by earlier and explained that it was Irish Gaelic that was being sung. He couldn't understand the title of track 9 but 7 was clear enough, _Harry's Game_. Dean knew Sam didn't know the language but guessed his little geek, emo little brother had just connected to the music on a level beyond the words and that he could understand because he felt that way about Led Zeppelin.

Sam shifted in the bed slightly and Dean looked up, "you okay? You need anything?" Dean stood up quickly. Sam's face was a little red in a discomfort and Dean understood, "It's okay Sammy, I'll go get Valerie, she's just in the kitchen." He placed a hand on his brother's right calf and gave a gentle squeeze. "See you when she's done Sammy."

**Later the Next Day**

"Well, be there tomorrow morning John," Cole assured. He glanced back at James in the backseat. The wards he'd made were working and their travel back to Bobby's had thus far been uneventful. The one minor problem was that John found that wherever James was within one mile of the young man there was no cell reception and he couldn't even check his damn voicemail, it was as if he gave off some frequency that blocked cell phones and he simply didn't want to waste time stopping and using a land line. He had made one very brief call to the hospital when they stopped for gas. The only response the information desk had given him was that records showed Sam had been discharged home. He took comfort in that; it had to mean Sam had bounced back from the aspiration, right? It was better to keep moving get James to Sam, to keep moving in order to keep James alive.

"The wards are working John," James spoke softly from the backseat. "These have never failed me. I will help your son," he comforted as he felt John's desperation. John nodded. "I am sorry about the cell phones, though," he offered lightly. "We could stop and use a pay phone to call your sons."

"They said he was discharged, right? I mean we could stop you could…" Cole offered. John shook his head.

"Just hurry Cole," his voice was low. Cole nodded tightly.

**Meanwhile, Bobby's House**

Dean looked at the clock at frowned. The day had slipped by so quickly. It was already a little after 4:00 PM. Sam had been quiet today but Dean had put in random quiet CD's that continued to play softly in Sam's room. He looked out over the salvage yard from the kitchen window. Valerie was checking Sam's diaper once again to make sure he wasn't wet. Sam had indicated he was uncomfortable but Valerie wanted to make sure. Dean rubbed a hand across his tired eyes. His mind over the last day had recounted a conversation he and Dr. Finley had had before Sam had been discharged. Dean still had trouble getting his mind around the fact that Sam had actually expressed what he wanted done after he died and had even found a man in town that Bobby knew that was a funeral director and ran his own funeral home. He knew about hunting and knew the body preparations needed to insure a hunter's body wasn't used by anything supernatural after death. Sam had indicated that he didn't care if he was cremated or buried just as long as it was handled by Bobby's friend. Sam had spoken Bobby's friend while he was able and plans were already arranged that when he died his body would go directly to the funeral home. Dean understood that this was an _expected_ death no autopsy would be needed. Dr. Finley would simply sign the death certificate when the funeral director brought it to his office. "Dean? You okay?" Bobby's voice made him turn.

"Huh? Yeah," he answered absently.

"You sure? You've been staring out that window for a good ten minutes now."

"Just lost in thought Bobby," Dena replied and the older hunter simply nodded in understanding. Valerie walked into the kitchen and her eyes betrayed her instantly. "What's wrong?" Dean's heart began to hammer against his sternum.

"Dean," she started tentatively. "He's indicated that he wants the mask removed and the BiPap machine turned off."

"It's only been four days, he…" Dean's jaw tightened and he turned away.

"Dean, honey," Valerie stepped forward. "He tapped on the mask and made a removing motion. He wants to have it removed. I have to honor his request." Dean turned around then.

"I'm…" he started and stopped.

"What?" she asked kindly, already knowing far too well. "Not ready to say good-bye, to let go," she said quietly. "Sweetie you never will be but this is about what he wants and he doesn't want to leave you but he's ready to go. He's tired, Dean," his eyes welled at that. Bobby simply stood stock still as his mind tried to assimilate the fact that Sam was really slipping away from them. He had always known it but he had held out hope until now.

"My Dad's still away," Dean offered as if it would change anything. Valerie had never been given an explanation as to where John had disappeared to, she had quietly assumed it had been too much for the Sam's father and he'd left to try and get his head on straight. It wouldn't be the first family member she'd had that left before the end. Some came back before it was too late and others didn't come back until it was over.

"He knows," she replied easily. "Dean," her hand fell on his forearm gently. "Even with the BiPap mask his vitals aren't holding. He's had drop in his blood pressure, his O2 sat's and heart rate, not significant drops, but his body has already begun to let go. Now, he's ready too," she squeezed lightly. This was never easy but it was her job to not only help her patient but the family, as well. "I'm not leaving at the end of my shift. I've already called Margaret and told her. I'll see this through with Sam, you … your family," she assured. "I'm here to keep Sam comfortable and offer what ever support I can to you and your uncle. I need to call Dr. Finley to advise him of Sam's decision. He wanted to know," she patted Dean's arm. "Go see Sam Dean, the mask is still on, he pointed at the door which as you know is his signal that he wants you, so go be with him. I'll be in soon to explain things to all three of you."

"Go be with Sam, Dean," Bobby's voice was rough with emotion. "I'll be in shortly." Dean turned desperate eyes between Valerie and Bobby. Hot tears welling and he rubbed angrily at them. He had to be strong for Sam, but how could he when his soul felt like it was dying right along with his little brother. He left to be with his brother.

He walked into the room quietly and Sam's head was turned toward the window. The sky had begun to change a little … it still showed the blue and clouds but the faintest of hue changes had begun to indicate that early evening was approaching. The BiPap machine continued its loud whooshing hum and Dean could see Sam's chest cave slightly at the forced in air as he breathed. Sam's eyes were closed and his face appeared free of any distress. Dean took a moment to look at the monitor and knew Valerie was right. Sam's blood pressure had dropped 70/60, his heart rate was now hovering around 67 and his oxygen level even with the machines help was now 89. Dean knew that wasn't good and that Sam should be on a ventilator but it wouldn't stop this and Dean knew it.

"Sammy?" Dean reached down and touched his brother's cheek with his thumb and rubbed a gentle circle as he used his other hand to pick up his brother's cool, limp one. "I'm here kiddo," he assured. Sam stirred then and turned his head. His eyes weakly roamed and then did settle on Dean's face. The eye contact was a gift for both of them. Sam squeezed Dean's hand. "Val told me what you want," Dean forced out past the tight constriction in his throat. "You sure?" Sam nodded weakly. "Okay." Dean's voice choked a little at that one word. Sam squeezed his hand again in comfort and support.

Bobby walked in and stood in the doorway. Dean turned and looked at the man. "Sammy, Bobby's here." The older man stepped forward.

"Hey, boy," he offered lightly. Sam offered a small smile at the _boy_ reference. Bobby walked around to the other side of the bed. He reached down and placed his hand on the crown of Sam's head. "I'm here," he assured with strength. Sam reached out a hand and grasped Bobby's calloused one and offered a weak squeeze. Bobby's Adam's apple bobbed slightly and his eyes misted. Sam looked back at his brother and was never more thankful that his eyes weren't betraying him like they were. He could actually look at his brother for long moments.

Valerie walked back into the room. "Sam," she started. "I've talked to your brother and uncle, now I want to tell you what to expect after the mask comes off, okay?" Sam nodded and Dean sat down at Sam's bedside and Bobby followed suit as he pulled up a chair. Dean and Bobby both felt numb but they had to bear this for Sam. "When the mask comes off, I'll replace it with a nasal cannula, so that you're still getting some oxygen and it will help keep you comfortable. The BiPap mask is forcing air in, so when it comes off you may feel like you're not getting enough air. It will pass as your body adjusts. I'll give you something for the anxiety to take the edge off. You'll be awake for as long as you're able and you'll start to feel sleepy as your oxygen levels get lower and your blood pressure drops, too. This may take a few hours." She paused and placed a comforting hand on his leg and gently squeezed a reassurance. "It's likely that before it's over you'll become unconscious, you'll just go to sleep and not open your eyes again … your body will shut down on its own. There won't be any pain Sam," she assured. "I'll make sure of that."

**Later that Evening, 9 PM**

The room was quiet and dimly lit by a small lamp in the corner. The only sounds in the room since the BiPap machine had been turned off and pushed against the wall were the quiet beeps from the IV pump. The oxygen tank made no noise and unless he listened closely Dean didn't hear the faint hiss of air as it delivered oxygen to his brother. Sam had struggled briefly after the mask was removed, the effort to breathe felt like he was drowning but Valerie had been right and the sensation diminished and as promised the anti-anxiety medication helped Sam adjust. He was quiet now but still mostly awake. Dean was alone with him now. Bobby had excused himself to allow the siblings time alone in these last hours. Valerie sat in the kitchen with Bobby sharing a cup of tea.

"You remember that Dairy Queen we stopped at outside Tyrone, Georgia that one time? I think you were five. Man, you had ice cream in places I still don't know how it got there," Dean chuckled quietly and Sam squeezed his hand. "I remember giving you your bath that night, you even had some dried ice cream behind your ear," Dean shook his head. "Dad, said no more ice cream unless I was willing to do the clean-up every time. I know you loved the stuff, so I made sure we got it at least a couple times a month when we got to towns that had some kind of ice cream."

Dean had crawled into bed with Sam and was pushed up against his side and had wrapped an arm under his brother's neck. Sam seemed comfortable and Dean needed to be as close as he could be. Sam nestled close and Dean fought the tears. He glanced at the monitor now moved off to the side. Valerie had put the alarms on silent as the changes in Sam's vitals were causing to bleep and buzz alarms, so they were muted but Dean could still see the numbers. Sam was still hanging on. His oxygen levels were at 85 now, his heart rate a slow but steady 64, his blood pressure had been sitting around 66/59 for the better part of two hours. Sam's hand tightened in Dean's briefly. "Okay, Sammy, I got more stories," Dean pushed on.

"You won't remember this 'cause you were too young, not quite six months yet. But, Mom and Dad took out for Halloween when you were five months old. Mom dressed you in a lion costume. You were too cute man, it was the whole shebang … like a jumpsuit she zipped you up in. I remember it 'cause I liked pulling on the tail and playing with you ears and Dad kept telling to leave you alone, but I was just playing. I was a fireman that year. Mom and Dad took us around the block and you lasted all of about half a block before you conked out for the rest of it. But, before you fell asleep you were totally into it Sammy. A lot of babies and little kids were crying at the kids dressed like monsters and zombies … you just giggled at them and waved your hands around. They didn't scare you. Mom and Dad took pictures that night, but you know …" Dean didn't need to elaborate he knew Sam understood that most of their family memories were destroyed in the fire just a couple days later. The camera burned without the film ever being taken out.

Dean kept up the talking for a while and finally he just hummed to Sam and stroked his brother's bangs from his forehand gently. Dean sat forward and made eye contact with his brother. Sam's eyes held his gaze. "Hey there little brother," he smiled warmly. "Just checking in," he replied. "You need anything Sammy, anything at all?" Sam's head barely shook side to side and Dean reached up and stroked an errant hair out of Sam's face. "Okay, just checking."

Dean curled back up with his little brother and let his chin rest on the crown of Sam's head. He breathed in is brother's smell … vanilla. Sam always smelled like vanilla. Sam held onto Dean's hand.

**4:00 AM Sam's Room**

Dean had been watching Sam drift in and out of short naps. He was struggling to stay awake and Dean knew that his sibling was trying to hang on for him as long as possible. Bobby had visited a short while ago and had talked to Sam, said he loved him like he was his own and then he'd turned anguished eyes to Dean reached out cupped his cheek and smiled. Leaving the boys alone once again. Valerie had checked the pain meds and anxiety medication. The fluid bags had been disconnected a while ago … Sam no longer needing them right now. He was hydrated and comfortable. Dean sat up and angled himself so that he could see his brother. "Sammy," his voice soft and it caught in his throat. "It's okay if you want to sleep. I'm here. I'm always gonna be here."

Sam's hand was still inside Dean's and he moved a couple fingers and wrapped them around Dean's thumb. Too weak to squeeze but stubborn enough to let Dean know he was still here, too.

**5:00 AM Sam's Room**

Dean glanced at the monitor as he had for the hundredth time in less than forty minutes. Sam's blood pressure was 60/40, his oxygen level was 79 and his heart rate had just dropped from 60 to 59. He was still fighting and Dean's eyes misted because he knew what he had to say, had to tell Sam … _it was time to let him go, time to let him let go, _both notions went against every big brother instinct Dean had in him.

"Sammy?" Dean stroked Sam's forehead and ran his hand up and back against Sam's long bangs. "You were right you know," his voice shook and caught in his throat but he had to say this, had to for Sam. "That letter you wrote me the one you had Bobby help you with," Sam moved a single finger inside Dean's palm to let him know he heard him, although his eyes were at half-mast. "You were right," he started again. "There is no …" he stopped as silent tears ran unchecked down his face. "There are no good-byes between brothers," he dropped his head and leaned it against Sam's. He turned inward and kissed his brother's forehead. He bent lower and whispered in his little brother's ear, this he could do, Sam deserved this, "I love you Sammy," his voice broke. "It's okay," he assured as he kissed the crown of his brother's head. "I know you can't stay little brother," he comforted. Sam's finger weakly stroked up and down on Dean's palm. He knew what Sam really needed to hear, "I'll be … I'll be okay," his voice broke again. "You sleep now Sammy, I'm here," Dean bent over and looked at his brother's face. Sam struggled and opened them just a bit wider and their eyes met and held. Sam offered the faintest of smiles, just a hint and he stroked his big brother's palm once more and Dean watched Sam close his eyes. Dean nuzzled closer and cried silent tears.

**6:00 AM Sam's Room**

It came on suddenly and pulled Dean up instantly. Sam's breathing shifted into this irregular pattern that terrified him. Sam's eyes were still closed and his face showed no signs of struggle but the breathing … he began oscillating between rapid shallow breaths and moments that he didn't breathe and then the rapid shallow breaths would start up again. "Valerie!" Dean shouted, it didn't bother Sam; he never stirred not even a flinch.

She came running into the room and recognized what was happening right away. Bobby stood in the doorway having heard Dean shout the care nurse's name. "Val, what's happening, he needs help…" Dean eased up and stood wanting Valerie to do something, anything.

"He's not in any pain Dean, this is a breathing pattern called Cheyne-Stokes, it's almost time, honey. He's letting go." Dean turned agonized eyes toward Sam and then up to Bobby.

"No, not yet…" he choked out a sob. "He's struggling," he practically begged as the strange breathing continued.

"No, sweetie he isn't, Sam's letting go and this isn't causing him any pain or fear," she assured. Sam's fast breathing would stop and it was the silence and the long moments of waiting to see his chest rise again that had Dean panicking.

"He's not breathing," Dean looked frenzied.

"It's called apnea Dean, it's what happens between the rapid shallow breaths," Valerie answered honestly. Sam's rapid breathing started up again. She glanced at the monitor and easily saw that Sam's blood pressure was beginning to really bottom out and his oxygen and heart rate were dangerously low. Dean saw her look and his eyes darted to the monitor and he felt his world fragment. "He'll pass soon Dean," her voice soft in the dim room.

The breathing kept on for another twenty minutes and Dean was now alone with Sam. The first streaks of morning light began to light the room but just barely. The golden light heralded a sunny day, "Sammy, the sunrise is coming," Dean curled into his brother. He was close to his ear now. He had once heard that hearing was the last sense to go when someone died. "Are you seeing it Sammy?" Sam's eyes were closed but he hoped that somehow he did.

The rapid shallow breaths came in a quick crescendo and then would stop and then a few more breaths and nothing … a couple breaths and then nothing … one breath and then a simple exhale and all was silent. Sam's chest didn't rise again. Dean's tear filled eyes looked at the monitor and he could see that his brother's heart was no longer beating. He gently pressed two fingers to his brother's pulse point in his neck and felt nothing.

"Sammy," he choked out as he removed the nasal cannula from his brother's nose and let it fall to the floor. He pulled Sam to him and cradled him, rocking and crying into his hair as he tucked Sam's head gently beneath his chin.

Bobby and Valerie heard the grief filled sobs coming down the hallway as the sun began to rise over the salvage yard. Valerie leaned forward and put a comforting hand on Bobby's arm. "It's over now, he's free." Bobby looked at his watch as did Valerie it was 6:20 AM, leaned forward and covered his face with a single hand and cried. Valerie sat with him knowing that a presence was sometimes all that was needed. There was nothing more she could do to ease Sam's passage from this world but she could be here to help his family through this tough morning.

**7:10 AM Bobby's House**

Valerie had made the call to Dr. Finley and notified him that Sam had passed. "Are you sure, I could stay," Valerie offered. She had already slipped in and removed the IV from Sam's hand and gently pulled off the electrodes that had been attached to the heart monitor. It was all pushed aside now. Sam lay peacefully in his bed with Dean still curled around him.

"No, Val you've done all you can. I'll call the funeral home and have them come in a while for Sam. I know Dean needs to be with him a while longer."

"I've made arrangements for the equipment to be picked up at the end of the week," she said gently. "I wanted to spare you the task. They'll call before they come, okay?"

"Thanks Val," Bobby pulled her into a quick hug. "Thanks for everything you've done, for Sam, for Dean," he paused. "For all of us." She simply smiled and nodded. They hugged once more and she walked out. Bobby felt hot tears sting his eyes. Sam was gone and he just couldn't get his mind around that, he wondered if he ever would.

**7:20 AM Bobby's House**

Bobby sat numbly at the kitchen table. He had looked in on Dean and felt he should let him be with Sam privately. He picked up the phone and dialed his friend in town. "Martin?"

"Bobby? It's early," the man paused. "Oh, Bobby, I'm sorry, when?"

"An hour ago," Bobby's voice wavered but he maintained.

"You need me to come now to get Sam?"

"Not yet, Dean's still with him."

"Call me; I can be there in fifteen minutes, okay?"

"Martin…"

"I'll take good care of that boy Bobby and that's a promise. John never showed up with the lead he had, huh?"

"No," Bobby's voice was quiet. He heard a car coming up the dirt driveway and by the cloud of dust behind it, it was coming fast. "Martin, I got company coming up the driveway. I'll call just as soon as we're ready, okay?"

"Sure thing friend, I'm here."

Bobby hung up and looked out the window and knew the red Pontiac, it was Cole Water's car. He went outside to meet them and saw how ragged John looked when he stepped out of the car. There was another creak of metal and a person Bobby didn't recognize got out. It was a younger man, maybe late 30's, coal black hair with ice blue eyes that looked through your soul, but they weren't harsh there was caring there and maybe a little fear. They shared a look and the man's breath caught in his throat. John spun around and looked at James.

"What?!" John was worried he felt the approach of an archangel or however it worked.

"I feel his grief, it's like a tidal wave." James stuttered.

"No, no not grief, you got it wrong kid," John assured. "Tell him Bobby. Look I know were late and I would have checked my phone but I can't get any reception around him," John flicked his thumb toward James. "This is James, he can heal Sam."

Bobby shook his head sadly and tears sprang to his eyes. "John," his voice broke and John felt his heart fall to his feet. "He's gone, Johnny … Sam's gone, he passed this morning about an hour ago. Dean was with him when he went … he's gone, I'm sorry," Bobby nearly sobbed. John shook his head in disbelief.

"No!" he shouted and tore past his old friend and went into the house. It was quiet and he walked slowly to Sam's room and stood paralyzed in the threshold. Dean was curled against Sam and had his head resting on the top of Sam's head. John looked at his baby son, he looked peaceful. His skin was milk pale and his lips were no longer pink but almost translucent. "Sammy?" he choked out and Dean looked at his father then.

"Where were you? He wanted you here, to see you … he couldn't speak but he still found a way to ask for you. Where the hell were you?" Dean's voice was filled with anger and grief but he never picked up his head from resting on Sam's.

"I found Sam's cure," John answered absently. His eyes fixed on his youngest child.

"You're too late," Dean sounded broken. "He's gone Dad … Sammy's gone." John looked at his first born and could see how fractured he was. John reached out and touched Sam's hand that rested on his stomach. Dean watched his father carefully. John felt the coolness in Sam's hand, saw the stillness of his chest and knew the truth, Sam, his baby boy was gone.

"Sammy," his voice broke. "My son, oh my son," he bent over Sam's body and pulled his hand to his face and flattened the cool palm against his own warm skin. He turned his face into Sam's limp hand and kissed the palm gently. He reached out and caressed a cheek and traced an eyebrow with his thumb.

"It may not be too late," a voice said from the doorway. John jerked around. Dean tensed and drew Sam closer. John didn't stop Dean, he was being a big brother to Sam no matter what, death didn't mean anything and John was proud of that.

"What do you mean, you can heal but…"

"I once said that I can heal anything and I can sometimes even … and I never finished. But, there is a window of opportunity in death where I can sometimes pull them back but we're running out of time I've never been able to do it past two hours and only if he hasn't crossed over yet. If his spirit still lingers there is hope, although there are no guarantees but if he's crossed I can do nothing." He stepped forward and Dean practically growled like a lion protecting its injured cub.

"You're not fucking touching him," Dean spat and put an arm protectively across Sam's still chest. "What the hell are you?!"

"Dean, this is James, let him help we might get Sammy back, please…" John would bodily separate his oldest from Sam if he had too. "He came to heal Sam, let him try before it's too late, if it's not already," John lamented as an almost after thought.

Dean relented as he looked at his brother's pale features and pulled himself away from Sam. James nodded and approached. "I need to touch him," he stepped forward tentatively. His eyes sparked with hope when he touched Sam. "His spirit hasn't crossed yet but he is very close. There is little time to try." James touched Sam's head and chest at the same time, he closed his eyes and within moments there was a warm glow emitting from his hands that seemed to envelope Sam's head and chest. The light grew to a bright all encompassing light and faded down to an ember; he pulled back and looked at Sam's silent features.

John, Dean, Bobby and Cole all stood transfixed and staring … silence filling the room.

**To Be Continued**


	16. The Light Wraps You

Disclaimer: refer to chapter one

**NOTE TO READERS: **Well, this is it the final chapter. The story is complete. Thanks for reading and for all of your reviews and PM's! This chapter is around 9 pages long and there is an end note to this story, as well. I utilize some time leaps in this chapter, too, but I had to otherwise, it could go on for another ten chapters. Thanks again for everything. Happy reading, I hope!

**Side Note: **This chapter was named for a Pablo Neruda poem by the same title.

**So Long, Good-Bye**

**Chapter Sixteen: The Light Wraps You**

By Dawn Nyberg

"…_Let the wind carry you home … may you never be broken again…"_ lyric excerpt by Alter Bridge, _Blackbird_

John, Dean, Bobby and Cole all stood transfixed and staring … silence filling the room. Dean stepped forward and looked at his brother. Hot tears cascading down his cheeks as Sam's chest remained still. John looked at his youngest with an agonized look. "Sammy?" he choked out. James looked at the broken family.

"I am sorry," he offered quietly.

A sudden, straggled gasp broke the anguished silence in the room and Dean felt light headed. "Sammy!" he nearly shouted as he immediately touched his brother's cheek and let one hand fall on his stuttering chest that hitched up and down as lungs once silent filled with life once again. Sam remained unconscious. "Sammy?" Dean's voice tentative as he ran a hand gently through his brother's long bangs.

John stepped forward, "It worked," his voice broke as he watched his child breathe. He cupped Sam's cool cheek and smiled warmly as he saw Sam's lips slowly begin to pink up and lose the awful translucence of death they had held moments before. "Why isn't he waking up?" John turned questioning eyes to James. "You healed him, so…"

James offered a slight shake of his head. "I healed the disease that was taking his life. It is gone but its effects remain." John and Dean frowned.

"What the hell does that mean?" they both said in unison. Dean kept a protective hand on Sam's head as his father turned to look at James fully.

"His body was weakened. He hasn't walked in a long time, he hasn't been able to eat normally," James listed things that John had told him on he long car drive here. "He'll need to regain his strength and unfortunately I can do nothing to speed that along. I have healed the disease and he will live, however, he will need help to regain himself once again."

"But, he'll be okay once he heals, gets stronger," Dean asked anxiously, his hand never losing contact with his little brother. James nodded. Dean let out a nervous breath and nodded.

"Thank you," John replied genuinely. Cole cleared his throat and everyone looked at him.

"Well, we'll leave you two alone with Sam. I'm thinking one night here and then I get James back to his place before our luck runs out." Everyone nodded. James had followed Bobby out toward the kitchen and Cole turned to leave. John extended a hand and stopped his old friend. Cole looked at him.

"I owe you, Cole, if you hadn't suggested … if you hadn't insisted someone like James did exist…" Cole shook his head and smiled. He reached up and clasped John's shoulder.

"No thanks needed man; you've saved my ass more times than I can count. I'm glad I was able to help. Sam's a good kid, always was … still is," he said with a smile as he looked at the very alive young man in the bed. John smiled in return and released his friend's shoulder. John needed to spend time with his boys.

**Two Days Later, Bobby's House**

Bobby had called Martin back an hour or two after James had healed Sam and told him what had happened, but nothing changed, Sam Collins was dead and certain things needed to be dealt with as not to draw attention. Martin had taken Sam Collins death certificate to Dr. Finley's office and the man had signed without question. Sam Collins was to be cremated and his ashes were to be spread in a _private family ceremony_ was all that was said to the doctor or in the small local paper as a small formality.

Bobby had called the medical companies that had supplied Sam's BiPap Machine and other equipment that hadn't been bought but rented and had arranged for an early pick-up. Sam was well hidden in the upstairs room while things were cleared out. Sam was as weak as a kitten and needed a lot of care. John and Dean, even Bobby knew that they needed help but not any local company that would know of Sam Collins, the dying PSP patient. Bobby knew of a retired hunter that was a doctor who could order the rehab care for Sam and any other items he may need during his convalesce.

"I gotta use the restroom Dean," Sam's voice was hesitant, tired and embarrassed.

"Here, Sammy," Dean was quick to pick-up the nearby portable hand held urinal.

"No," Sam snapped out. Dean was thankful his brother's speech had returned with no difficulties but he was still adjusting to eating again and right now Dean had returned to purees and had graduated up to other soft foods and some clear soups. Sam still couldn't stand on his own at all. His legs unwilling to support him on muscles that hadn't been used in a while. The physical therapy they had given Sam while he was ill had helped but muscles still weakened from lack of their real usage.

"Look Sammy, I know you hate it but…" Dean turned away while his brother relieved himself and then took the plastic urinal from him and excused himself to go empty it in the toilet and rinse it out.

"Sam, son," John stepped into the room while Dean was gone. "Bobby is making some calls we're going to get some help in here for you. I know you don't like us doing it for you. He's also making sure they can get some rehabilitation services out here, too. He talked to one company that comes to the home and also has an outpatient rehab center that you go to for more advanced rehab. You'll be back to your old self soon," John assured.

Sam looked away out the window of the second story room. He had woken up in this room and knew his family had to have carried him up here. He still felt trapped in his body weakened by a disease that almost killed him … _did_ kill him. He was too tired to try and think about the person that had healed him, a Nephilim, he hadn't met the man but had been told about him. He wished he could forget the past months but he remembered every moment even the ones before he lost consciousness nearing his own death. He remembered his big brother being there for him until his eyes closed and was sure Dean had been with him even as he took his last breath and after. "Sammy," John's voice was gentle as he placed a hand on his leg. "I know you're processing a lot, I do," he replied. "But, it will get better," he assured. "We're getting you what ever you need to get back on your feet." Sam looked at his father then and gave a small smile.

"I know Dad, thanks," Sam's voice was quiet. He looked at the door as his brother walked back in.

**Two Days Later**

Bobby and John had got the ball rolling quickly and Sam was already set back up in the library with a new hospital bed and was getting regular PT visits. His new doctor, Lyle Marcum, M.D., visited once a week. He had known Bobby almost ten years now and owed him more than one favor. Sam had been able to keep the wheelchair and walker as those items had been purchased and didn't need returned. There were other small items that helped him get back to caring for himself in some ways. He could bathe himself but needed a shower chair to sit on, but he needed help getting in and getting out because he couldn't stand on his own.

There was a new home care company that Lyle had suggested for the Winchester's to use, or as they were now called, the Callison Family staying at their uncle's. Sam's back story was he'd been in an accident and developed a life threatening infection that had left him weakened and being fed by a feeding tube. However, he was on the mend now and needed PT and some home care until he was able to fully care for himself.

Joyce, the care nurse from _Gentle Touch Home Care_, was a nice middle-aged woman that Sam liked but she wasn't Val. He missed her but knew he could never ever see her again; after all, her patient Sam Collins was dead and had been for four days now. This company worked in 12 hour shifts, so the patient was covered 24 hours a day which meant there was never a time unless Sam or the family gave them the go ahead to leave early that Sam was without someone. Sam only needed help transferring from his bed to wheelchair and in the bathroom they used the lifting apparatus to get in the bathtub. He needed help with some of his dressing since he couldn't lift his legs enough to put on his boxers or PJ bottoms. He needed help to the restroom but insisted on doing as much as he was capable of doing before having the care nurse help him. He hated still feeling helpless but now he could fully communicate and that meant the world to him. He hated remembering how helpless he felt when he couldn't express himself.

Marcus Oliver was his physical therapist he came to the house two days a week and a PT transport came for Sam three times a week to take him to their rehab facility outside town where he could do more advanced PT and get hydrotherapy. Dean had fought him on the transport but Sam had won out saying he needed some independence and the PT transport could accommodate his wheelchair easily and had a wheelchair lift.

"Sammy, lunch time," Dean chimed with a big smile. Joyce looked up from arranging supplies and smiled.

"Thrilling, what's on he menu today?" Sam's voice was unenthused.

"Hey, Mr. Sunshine, as soon as you can eat regular stuff without it making you sick then you won't have to eat this crap but until then doctor's orders. It's some chicken broth soup, a vegetable puree of peas and carrots and for dessert chocolate mouse the doc had me add some stuff to for more vitamins." Dean knew Sam hated this stuff but the simple fact was that Sam's body hadn't adjusted to solid food yet and it would be a slow process, the kid had been on liquids and thickened liquids for a long while and they had tried solids once with just a small piece of bread soaked in milk and Sam had vomited it up, so they were on this modified plan that would slowly introduce things into his system and move back up to full solids.

Sam could see his big brother's efforts to make things good for him and he appreciated it. He offered a small dimpled smile, "Thanks," he offered quietly. Dean nodded and sat the food down. He was thankful his little brother could feed himself at least, so that was one brighter spot in Sam's slow recovery.

**Later that Afternoon**

John walked into the house with the mail he'd collected at the end of the long driveway as he returned from town. Dean sat on the couch with his feet up giving Sam some space as his kid brother napped from exhaustion from his earlier PT session. John dropped a couple opened envelops into Dean's lap. "What are these?" he asked as he picked up one and pulled out a card. He felt sick to his stomach; it was a sympathy card from _Comfort Keepers_ and was signed by Valerie and Margaret. He looked at the second envelope and it was a card from Dr. Finley's office and signed by him. Dean looked up at his father and John sighed and sat heavily down on the couch next to his son.

"I know," he started. "Even knowing he's still with us it still hit me like a ton of bricks when I saw they were Sympathy cards. We didn't lose him Dean, he's gonna be okay."

"I know," Dean's voice was hesitant. "But, you weren't there Dad when he … when Sammy …" Dean stared at his hands. John dropped a hand on one of Dean's knees and squeezed.

"I'm sorry," he offered. "When I got here and thought it was too late, when I saw you with him and knew he was gone … I can't describe …" John shook his head. "Sammy's gonna be fine," he said again. "You know he's not going to be ready to hunt again for a while Dean…"

"I could care less about that Dad," Dean turned angry eyes toward his father. "I just want him back on his feet, to gain the weight back …" John raised submissive hands.

"Hey, I didn't mean … I know your brother needs time and his health is my first priority, well yours and his are," John offered a small smile. "We'll get him back on his feet."

"You're staying?" Dean looked surprised.

"Well, until he's at least walking again and the home care is over. The demon can wait," John assured. "I know he's got a rough road ahead of him getting back on his feet … recovering … but he will recover Dean. Sammy's a Winchester which makes him one hell of a fighter. Plus, he has us and Bobby …" Dean looked at his father and gave the man a genuine, full fledged Dean Winchester smile.

"Thanks Dad," he replied quietly. John shook his head. There was no thanks needed between father and son.

**One Month Later**

Dean was standing in the kitchen as Joyce walked in, "Sam okay?"

"Sure, he told me to take five, so to speak, so …"

"You mean he wants some space, eh?"

"Well, I can't blame him. He's seems the independent type and I'm sure this lengthy convalescence and rehab is getting under his skin," she offered bluntly.

"Yeah, Sammy can be stubborn but I guess it's in the family genes," he smirked. Sam had been getting rehab at home and going to the rehab center quite often during the weekdays and was able to stand on his own but walking was still a task he was trying to get under control. Dean was about to offer Joyce a cup of iced tea when a loud crash followed by an even louder _Dammit_ echoed down the hallway to the kitchen. They ran with Dean in the lead.

He ran into the library that was still Sam's room as he continued to heal. They both looked at the bed and promptly saw that it was empty. Dean darted around the side and found Sam trying to get up but not having enough leg strength to get up from the floor. Sam slapped the floor in anger, "Sonofabitch!" he barked.

"Sammy?! You okay?" Dean and Joyce both started to help Sam up and he slapped Dean's hand away.

"I just wanted to take a piss and I can't even walk to the friggin' bathroom," Sam was fuming and then Dean caught a glimpse of blood droplets on the wood flooring.

"Are you hurt?!" Dean barked. He knelt by his brother quickly.

"I'm fine just clipped my damn forehead on the walker. "It's nothing," Sam tried to fend off Dean's examining hands. "Get off," he hissed. "I said I'm fine." Dean easily overpowered his sibling. He pushed back his little brother's bangs gently and examined his forehead.

"Crap Sammy," Dean complained. "Joyce pass me a clean washcloth," he wanted to clean away and staunch the blood flow to get a better look at the head wound.

"Dean, I can look at it," Joyce offered as she knelt by her patient.

"Yeah, I know, but I'm not new to this … he was a little kid once …" he offered with a light tone.

"Don't talk about me like I'm not here," Sam complained.

"You're going to need stitches ya dumb ass," Dean growled. "Dammit Sammy, you could have really hurt yourself." Dean was about to continue his angry tirade spurred by his earlier terror that Sam was seriously hurt but he stopped short when Sam's face reddened slightly and he looked down and he saw the dark wet spot growing on his brother's light colored sweatpants. He had held it as long as he was able and now he'd wet himself. "Sammy," his voice softened.

"I just wanted to use the damn bathroom on my own," Sam spoke quietly still not looking at his brother. "Please, just go," his request a plea. Dean wanted to say more but knew better not to and Joyce's gentle hand on his shoulder just reinforced that for him.

"Dean, I just need some help getting him to his bed … and then Sam and I have it from there, okay?" Dean nodded silently and helped get his little brother up and standing and supported him as he shuffled two wobbly steps to the bed and sat down on the edge. He gently squeezed Sam's shoulder and left without saying anything.

**One Hour Later**

Lyle Marcum walked into the kitchen and surveyed the full kitchen table, John, Bobby and Dean sat there waiting with expectant eyes. "How's my boy?" John spoke first.

"The cut was an easy stitch shouldn't even really scar. It took eight stitches to close. There's no sign of head injury or any other injuries. He's going to be fine."

"Thanks Lyle," Bobby chimed in.

"Is he really okay?" Dean asked quietly. Sam hadn't wanted to see anyone since he'd had help getting back to bed after wetting himself.

"Physically he's getting there but emotionally the kid has been through a lot and the little incident today was upsetting to him but he'll bounce back. We've made sure he has a bedside urinal at his disposal, so that he can go when he wants if no one is around. He's been going gang busters on his PT, so hopefully in another month or two with the help of the walker he'll be able to take himself down the hall to the bathroom on his own. He's already able to stand on his own, support his own weight, it's just the walking thing that is still problematic but fully expected considering the length of time he was sick and bedridden."

Everyone in the kitchen nodded but said nothing.

"Well, I'm going to head out. If Sam needs anything don't hesitate to call me and I'll stop by tomorrow afternoon to check on him, okay?"

"Thanks Lyle, I owe you one," Bobby stood up and clasped his friend's shoulder. The former hunter smiled.

"Nah, old friend, I still owe you a few and anyway Sam's a good kid. I'll see all of you tomorrow."

**Six Months Later, Bobby's House**

"You really have to go Dad," Sam asked as he stood by his brother in front of Bobby's porch.

"Yeah, kiddo, I have a few leads on the demon and you're up and around now," he gently swatted Sam's stomach. "And, putting back on some weight." Sam smiled.

"We could go with you dad, we're stronger together," Sam added quickly. John shook his head slightly and looked at his son lovingly.

"Not this time kiddo," he replied gently. "You still got some mending to do and I'll be in touch, I promise it won't be like before … I'll answer my phone when I can and return any missed calls."

"We'll be okay Dad," Dean assured. "Sammy here will be 100 percent in another month or two and we'll get out of Bobby's hair." It was true Sam was able to care for himself now and no longer needed the home care company. He could bathe himself, walk without the walker and his PT was now a home regimen that Dean helped him with and no longer required the therapist. Sam could eat solid food once again, too. He was putting back on weight and most importantly more muscle mass to replace what he'd lost. But, he still tired after workouts and walking around. He couldn't really run yet and in their line of business you had to be able to run at a moment's notice, so Sam was still recovering and Dean wasn't going to let him return to hunting until he was sure his little brother was ready.

"Thanks for staying dad," Sam offered quietly. "It was nice having you around." John offered up a surprised look. Sam smiled at the look and Dean snickered.

"Never thought I'd hear that," Dean offered candidly between chuckles. John barked a laugh. He loved his boys.

**Two Months Later**

"Well, you boys take care of each other and if you need anything, _anything_ at all you got my number and you know you're welcome here whenever, so don't be strangers, okay?" Bobby smiled at the young men. "Man, will it be quiet around here when you two aren't around."

"What? We haven't been driving you crazy Bobby?" Dean asked in an amused voice. "Didn't you threaten to get your shotgun the other night…" Bobby chuckled.

"Yeah, yeah," he replied amicably. "Seriously, though, you boys are welcome here anytime."

"Thanks Bobby," Sam offered the older man a dimpled smile and stepped forward and hugged the man. Bobby returned the hug. Bobby released Sam and looked at Dean.

"Now, you're not getting off that easy boy, come here," he smiled. Dean rolled his eyes.

"Ah, man," he kidded. "I mean really…" he acted all appalled but returned the hug with a genuine fierceness that held nothing but affection for the man they considered their uncle.

Dean and Sam climbed into the Impala and the engine rumbled to life. Dean looked over at his little brother and smiled. Sam was healthy and was back to his old self. It hadn't been an easy road back for Sam but he had pushed through and had come through the other side stronger for it, they both had.

"You ready Francis," Dean kidded. Sam scrunched his face at that.

"Jerk, and yeah I'm good," he answered lightly as they started to pull away. They both waved at Bobby and drove away from the house.

The Impala kicked up dust on the dirt and gravel driveway and Dean put in AC/DC and as _Back in Black_ came on, he looked at his little brother and their eyes met, he smiled and replied easily, "bitch." Sam chuckled as he gave a lopsided dimpled grin and Dean felt the final piece of his fragmented soul knit back in place and he was whole once again.

**The End**

**End Note: **When I had come up with this story idea during season 3 I had filed it away in my fanfic idea folder and figured I get to it when I had time. This was originally going to be a death fic … yes, I was actually going to have Sammy die and the Nephilim wasn't going to be able to save him. He was going to be cremated and on the one year anniversary of his death I was going to have Dean scatter Sam's ashes at Jessica's and their mother's gravesites. Anyway, it wasn't very long into this story when I lost my mom and suddenly I just couldn't do a death fic … I've been drowning in reality for too long, so I decided to give the boys a happy ending. I know some people were disappointed by the fact I saved Sam, because well, most of the time people don't get happy endings … and it's true most of the time they don't … I sure haven't had any in my life recently, so I did have the power to change the original course of this story and give the boys a happy ending, so I did. I appreciate every email, PM and review I was given and I want to thank everyone for sticking with this story. Thank You!!!!

Also, to everyone that emailed condolences when I lost my mom and that continue to send emails to see how I'm doing … your kindness, friendship and warmness is more than I deserve and I thank you whole heartedly for it. Bear hugs for all of you!


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